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经十二指肠手术切除壶腹内乳头状管状肿瘤（IAPN）：一例病例报告。

Transduodenal surgical ampullectomy for intra-ampullary papillary tubular neoplasm (IAPN): A case report.

作者信息

Pradhan Susan, Adhikari Krishna Mohan, Dahal Romi, Pradhan Sumita, Bhandari Ramesh Singh

机构信息

Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Kathmandu, Nepal.

Department of GI and General Surgery, Tribhuvan University Teaching Hospital, Institute of Kathmandu, Nepal.

出版信息

Int J Surg Case Rep. 2021 Sep;86:106253. doi: 10.1016/j.ijscr.2021.106253. Epub 2021 Aug 1.

DOI:10.1016/j.ijscr.2021.106253
PMID:34388591
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8363816/
Abstract

INTRODUCTION AND IMPORTANCE

Intra-ampullary papillary tubular neoplasms (IAPNs) are relatively rare kind of neoplasms occurring in the region of the papilla which exhibit significant malignant transformation. The patient was concerned about his pain and the possibility of malignancy.

CASE PRESENTATION

We report a case of a 47-year-old male who presented with persistent upper abdomen pain. Following detail investigations, he was diagnosed as IAPN and managed by transduonal ampullectomy (TDA).

CLINICAL DISCUSSION

The insidious onset of IAPN along with its high risk of malignancy makes it mandatory for its proper treatment. Although, endoscopic approach is advantageous for initial therapy, it has some technical difficulties. Hence TDA forms the cornerstone in the management of IAPN with good prognosis.

CONCLUSION

Transduodenal ampullectomy is a safe and feasible option for IAPN. It can be the first choice of treatment in selected cases where endoscopic papillectomy is not available.

摘要

引言与重要性

壶腹内乳头状管状肿瘤（IAPN）是发生在乳头区域的一种相对罕见的肿瘤，具有显著的恶变倾向。患者担心自己的疼痛以及恶性肿瘤的可能性。

病例介绍

我们报告一例47岁男性患者，表现为持续性上腹部疼痛。经过详细检查，他被诊断为IAPN，并接受了经十二指肠壶腹切除术（TDA）治疗。

临床讨论

IAPN起病隐匿且恶变风险高，因此必须进行恰当治疗。虽然内镜治疗方法对初始治疗有利，但存在一些技术难题。因此，TDA是IAPN治疗的基石，预后良好。

结论

经十二指肠壶腹切除术对IAPN是一种安全可行的选择。在无法进行内镜乳头切除术的特定病例中，它可以作为首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/48dceb2e9603/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/104f01677d23/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/07ae0e50f3c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/2bd44ac6e7d9/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/ba9088ce1a04/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/80c7471c611c/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/48dceb2e9603/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/104f01677d23/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/07ae0e50f3c0/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/2bd44ac6e7d9/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/ba9088ce1a04/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/80c7471c611c/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b9e/8363816/48dceb2e9603/gr6.jpg

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