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肝硬化患者胃底静脉曲张氩离子凝固术后胃增生性息肉:“胃泌素关联理论”提示的 1 例

Gastric Hyperplastic Polyps after Argon Plasma Coagulation for Gastric Antral Vascular Ectasia in Patients with Liver Cirrhosis: A Case Suggesting the "Gastrin Link Theory".

机构信息

Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Japan.

Department of Hepatology and Pancreatology, Kawasaki Medical School, Japan.

出版信息

Intern Med. 2021 Apr 1;60(7):1019-1025. doi: 10.2169/internalmedicine.5837-20. Epub 2020 Oct 28.

Abstract

We herein report a case of gastric hyperplastic polyps after argon plasma coagulation (APC) for gastric antral vascular ectasia (GAVE) in the antrum of a 65-year-old man with liver cirrhosis and hypergastrinemia induced by long-term proton pump inhibitor (PPI) use. Two years after APC therapy, endoscopy demonstrated multiple gastric polyps in the antrum and angle. A gastric polyp biopsy indicated foveolar epithelium hyperplasia, which was diagnosed as gastric hyperplastic polyps. One year after switching to an H2 blocker antagonist, endoscopy revealed that the polyps and GAVE had disappeared, with normal gastrin levels suggesting that PPI-induced hypergastrinemia had caused gastric hyperplastic polyps after APC therapy, and the polyps had disappeared after discontinuing PPIs.

摘要

我们在此报告一例 65 岁男性患者,因长期使用质子泵抑制剂(PPI)导致肝硬化和高胃泌素血症,行氩等离子凝固(APC)治疗胃窦部胃底腺血管扩张症(GAVE)后出现胃增生性息肉。APC 治疗 2 年后,内镜检查显示胃窦和胃角多发胃息肉。胃息肉活检提示固有腺上皮增生,诊断为胃增生性息肉。改用 H2 受体拮抗剂 1 年后,内镜检查显示息肉和 GAVE 消失,胃泌素水平正常,提示 PPI 诱导的高胃泌素血症导致 APC 治疗后胃增生性息肉,停用 PPI 后息肉消失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed4/8079916/c6299ea3f0d8/1349-7235-60-1019-g001.jpg

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