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内镜黏膜下剥离术后胃壁脓肿

Gastric wall abscess after endoscopic submucosal dissection.

作者信息

Yu Seung Jung, Lee Sang Heon, Yoon Jun Sik, Lee Hong Sub, Jee Sam Ryong

机构信息

Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

出版信息

Clin Endosc. 2023 Jan;56(1):114-118. doi: 10.5946/ce.2021.203. Epub 2022 Jan 3.

Abstract

Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.

摘要

胃壁脓肿是蜂窝织性胃炎的一种局限性形式,是内镜切除术后罕见的并发症。我们报告韩国首例内镜黏膜下剥离术后发生胃壁脓肿的病例。一名72岁女性到我们诊所接受胃腺瘤治疗。患者成功接受了内镜黏膜下剥离术,无并发症。最终诊断为高分化管状腺癌。10周后我们进行了随访内镜检查,发现胃窦后壁有一个大的上皮下病变。腹部计算机断层扫描显示胃窦黏膜下层有低密度壁增厚和一个5厘米的异质性多叶肿块。因此不能排除黏液腺癌的黏膜下浸润。由于可能存在高度恶性病变,患者同意接受额外的胃切除术。最终诊断为急性化脓性炎症,在壁层和网膜中形成多个脓肿。患者出院时无并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08cf/9902681/0d7c8924dc67/ce-2021-203f1.jpg

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