Michael Okello, Derick Kayondo, Ponsiano Ocama
Department of Anatomy, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda; Uganda Martyrs Hospital Lubaga, P.O. Box 14130, Kampala, Uganda.
Uganda Martyrs Hospital Lubaga, P.O. Box 14130, Kampala, Uganda.
Int J Surg Case Rep. 2021 Dec;89:106632. doi: 10.1016/j.ijscr.2021.106632. Epub 2021 Nov 25.
Gastroduodenal intussusceptions are rare and usually secondary to gastric lesions acting as the lead point. Gastrointestinal stromal tumors (GISTs) commonly occur in the stomach (40-60%). Other gastric tumors include; adenocarcinomas, leiomyomas, lymphomas among others. When gastric tumors act as lead points in gastroduodenal intussusception, pancreatitis may arise due to compression of the ampulla of Vater or pancreatic head. Gastroduodenal intussusception may mimic other inflammatory upper gastrointestinal conditions leading to delays in early diagnosis and timely intervention.
A twenty three year old female with gastroduodenal intussusception secondary to a gastric body GIST with associated pancreatitis. This gastroduodenal mass was initially diagnosed as a pancreatic head echo-complex mass by ultrasound. Confirmatory preoperative diagnosis was made after doing contrasted abdominal computed tomography (CT) scan and upper gastrointestinal endoscopy. Open gastric wedge resection was done. Patient had uneventful recovery and was discharged on the fifth postoperative day.
Gastroduodenal intussusceptions have non-specific clinical features that may lead to delays in making the correct diagnosis. CT scan is a good imaging modality for diagnosing this condition but access is limited in low resource settings. Resection of the organic cause after reducing the intussusception leads to resolution of the symptoms caused by the intussusception, the GIST and the resultant pancreatitis.
Gastroduodenal intussusception is rare and may present with nonspecific clinical features. Pancreatitis may arise due to the compression effects on the ampulla of Vater or pancreatic head. A high index of suspicion is key in making a timely diagnosis.
胃十二指肠套叠较为罕见，通常继发于作为套叠起点的胃部病变。胃肠道间质瘤（GIST）常见于胃部（40 - 60%）。其他胃部肿瘤包括腺癌、平滑肌瘤、淋巴瘤等。当胃部肿瘤作为胃十二指肠套叠的起点时，可能由于 Vater 壶腹或胰头受压而引发胰腺炎。胃十二指肠套叠可能类似其他炎症性上消化道疾病，导致早期诊断和及时干预延迟。
一名23岁女性，因胃体部胃肠道间质瘤伴发胰腺炎导致胃十二指肠套叠。该胃十二指肠肿物最初经超声诊断为胰头回声复杂肿物。在进行腹部增强计算机断层扫描（CT）和上消化道内镜检查后做出了术前确诊。实施了开放性胃楔形切除术。患者恢复顺利，术后第五天出院。
胃十二指肠套叠具有非特异性临床特征，可能导致正确诊断延迟。CT扫描是诊断这种疾病的良好影像学方法，但在资源匮乏地区难以获得。在复位套叠后切除病因可使由套叠、胃肠道间质瘤及由此引发的胰腺炎所导致的症状得到缓解。
胃十二指肠套叠罕见，可能表现出非特异性临床特征。胰腺炎可能因对 Vater 壶腹或胰头的压迫作用而产生。高度怀疑指数是及时诊断的关键。
