Li Jian, Wang Qiu-Qiu, Xue Shuai, Zhang Yan-Yan, Xu Qin-Yu, Zhang Xiao-Hong, Feng Li
Endoscopy Center, Minhang Hospital, Fudan University, Shanghai 201100, China.
World J Clin Cases. 2022 Jan 21;10(3):1099-1105. doi: 10.12998/wjcc.v10.i3.1099.
Submucosal tumors (SMTs) refer to elevated lesions that originate from the layers below the mucosa of the digestive tract, including the muscularis, submucosa and muscularis propria. With the development and application of endoscopy and endoscopic ultrasonography (EUS), the detection rate of SMTs has increased significantly in recent years. Various diseases can lead to SMTs. However, a foreign body embedded in the gastric antrum showing clinical manifestations of a SMT is rare.
We report the case of a 47-year-old woman, who presented with upper abdominal discomfort for one year, and was subsequently diagnosed with a gastric submucosal lesion caused by an embedded foreign body by EUS and computed tomography. Considering the size and potential complications of this lesion, endoscopic full-thickness resection was performed to achieve full resection in our endoscopy center. A fish bone was found in the lesion during the operation, and was successfully removed, and the defect was later closed with endoscopic purse-string sutures.
This case report highlights the management strategies of SMTs, the importance of being familiar with diagnostic methods related to submucosal lesions, and being able to conduct effective treatment when this rare condition is highly suspected.
黏膜下肿瘤(SMTs)是指起源于消化道黏膜以下各层的隆起性病变,包括肌层、黏膜下层和固有肌层。随着内镜及内镜超声(EUS)技术的发展与应用,近年来SMTs的检出率显著提高。多种疾病可导致SMTs。然而,胃窦部嵌入异物并表现出SMT临床症状的情况较为罕见。
我们报告一例47岁女性患者,她上腹部不适一年,随后经EUS和计算机断层扫描诊断为异物嵌入导致的胃黏膜下病变。考虑到该病变的大小及潜在并发症,我们在内镜中心进行了内镜全层切除术以实现完整切除。术中在病变处发现一根鱼刺,并成功取出,随后用内镜荷包缝合关闭缺损。
本病例报告强调了SMTs的处理策略、熟悉黏膜下病变相关诊断方法的重要性,以及在高度怀疑这种罕见情况时能够进行有效治疗。