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胃内异位胰腺组织:一例报告。

Ectopic pancreatic tissue in stomach: A case report.

作者信息

Paramythiotis Daniel, Kollatou Angeliki Sevasti, Simou Theodora, Karlafti Eleni, Abba Deka Ioanna, Petrakis Georgios, Didangelos Triantafyllos, Michalopoulos Antonios

机构信息

First Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, 55636, Thessaloniki, Greece.

Emergency Department, AHEPA University General Hospital of Thessaloniki, 55636, Thessaloniki, Greece.

出版信息

Ann Med Surg (Lond). 2022 Jun 14;79:104005. doi: 10.1016/j.amsu.2022.104005. eCollection 2022 Jul.

Abstract

INTRODUCTION AND IMPORTANCE

Ectopic Pancreas (EP) is a rare condition that is mostly found in the Gastrointestinal tract and especially in the stomach. Although the lesion is mainly asymptomatic, non-specific symptoms can be present, making the diagnosis even more challenging.

CASE PRESENTATION

In our case a 52-year-old woman, with heartburn as the only symptom, was undergone successive examinations, indicating a subepithelial lesion in the antrum of the stomach, from which only Magnetic Resonance Imaging (MRI) indicated the presence of ectopic pancreas, while Computed Tomography results considered the mass as Gastrointestinal Stromal Tumor. Wedge gastrectomy was performed in order to extract the lesion and the histopathological examination confirmed the findings of the MRI. The patient fully recovered with no complications.

CLINICAL DISCUSSION

In most cases, EP is described in endoscopy as a subepithelial mass with normal mucosa. As EP can mimic other subepithelial masses, even adenocarcinoma, it is of utmost importance not to omit the performance of surgical removal and histopathological examination. Consequently, resection is essential not only for the diagnosis but also for the treatment of the patient.

CONCLUSION

EP is not a usually detected clinical pathology. There is no specific algorithm, which physicians should follow in order to reach the diagnosis without the surgical intervention. For this reason, clinicians should be conscious of the existence of EP in the stomach.

摘要

引言与重要性

异位胰腺(EP)是一种罕见病症,多见于胃肠道,尤其是胃部。尽管该病变大多无症状,但可能出现非特异性症状,这使得诊断更具挑战性。

病例介绍

在我们的病例中,一名52岁女性,唯一症状为烧心,接受了一系列检查,显示胃窦有上皮下病变,其中只有磁共振成像(MRI)提示存在异位胰腺,而计算机断层扫描结果认为该肿块是胃肠道间质瘤。为切除病变进行了楔形胃切除术,组织病理学检查证实了MRI的结果。患者完全康复,无并发症。

临床讨论

在大多数情况下,内镜检查将EP描述为具有正常黏膜的上皮下肿块。由于EP可模仿其他上皮下肿块,甚至腺癌,因此绝不遗漏手术切除和组织病理学检查至关重要。因此,切除不仅对诊断至关重要,对患者的治疗也至关重要。

结论

EP不是一种通常能检测到的临床病理。没有特定的算法可供医生遵循,以便在不进行手术干预的情况下做出诊断。因此,临床医生应意识到胃部存在EP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b144/9289346/169f45e40f34/gr1.jpg

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