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小肠淋巴管瘤的临床表现与治疗:15例单中心分析

Clinical manifestation and treatment of small intestinal lymphangioma: A single center analysis of 15 cases.

作者信息

Wang Zhen-Zhen, Shen Ling-Yan, Zhou Jing-Jing, Tang Jia-Li, Ye Li-Ping, Shen Chen-Bo, Li Shao-Wei, Zhou Xian-Bin

机构信息

Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.

Key Laboratory of Minimally Invasive Techniques and Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital Affiliated to Wenzhou Medical University, Linhai, Zhejiang, China.

出版信息

Front Med (Lausanne). 2022 Sep 23;9:975698. doi: 10.3389/fmed.2022.975698. eCollection 2022.

Abstract

BACKGROUND

Small intestinal lymphangioma is a very rare benign lesion. Thus far, the literature on small intestinal lymphangioma has mainly involved case reports. The present study retrospectively examined the clinical features of patients with a pathological diagnosis of small intestinal lymphangioma.

MATERIALS AND METHODS

From January 2010 to January 2021, 15 patients were pathologically diagnosed with small intestinal lymphangioma. The age, gender, clinical manifestation, computed tomography (CT) findings, endoscopic findings, localization of the lesion, treatment method, complications, and follow-up were retrospectively analyzed.

RESULTS

Most of the patients had no symptoms, and those with symptoms had melena or abdominal pain. Lymphangioma was located in the duodenum in nine cases (60.0%), jejunum in two (13.3%), jejunal-ileal junction with mesentery involvement in one (6.7%) and ileum in three (20.0%). Three cases (20.0%) had multiple lesions, and the other 12 (80.0%) had single lesions. The median size of the lesions was 0.8 cm. Thirteen cases were found by endoscopy, and nine cases of them had white-colored spots on the surface. Ten cases (66.7%) underwent endoscopic treatment, three (20.0%) underwent surgical treatment, and two (13.3%) were followed up. Postoperative acute pancreatitis developed in one patient after endoscopic resection of duodenal papillary lymphangioma; postoperative abdominal bleeding occurred in one patient with jejunal lymphangioma who underwent partial small bowel resection.

CONCLUSION

Small intestinal lymphangioma is extremely rare, and its clinical manifestations are non-specific. Endoscopy is of great value in the diagnosis of small intestinal lymphangioma. Depending on the clinical manifestations, the size, location and scope of the lesions, follow-up, endoscopic treatment and surgery can be selected.

摘要

背景

小肠淋巴管瘤是一种非常罕见的良性病变。迄今为止,关于小肠淋巴管瘤的文献主要是病例报告。本研究回顾性分析了经病理诊断为小肠淋巴管瘤患者的临床特征。

材料与方法

2010年1月至2021年1月,15例患者经病理诊断为小肠淋巴管瘤。对患者的年龄、性别、临床表现、计算机断层扫描(CT)结果、内镜检查结果、病变部位、治疗方法、并发症及随访情况进行回顾性分析。

结果

大多数患者无症状,有症状的患者表现为黑便或腹痛。淋巴管瘤位于十二指肠9例(60.0%),空肠2例(13.3%),空肠-回肠交界处伴肠系膜受累1例(6.7%),回肠3例(20.0%)。3例(20.0%)有多处病变,其余12例(80.0%)为单发病变。病变的中位大小为0.8cm。13例通过内镜检查发现,其中9例表面有白色斑点。10例(66.7%)接受了内镜治疗,3例(20.0%)接受了手术治疗,2例(13.3%)进行了随访。1例十二指肠乳头淋巴管瘤内镜切除术后发生术后急性胰腺炎;1例空肠淋巴管瘤行部分小肠切除术后发生术后腹腔出血。

结论

小肠淋巴管瘤极为罕见,其临床表现无特异性。内镜检查对小肠淋巴管瘤的诊断具有重要价值。根据临床表现、病变大小、位置和范围,可选择随访、内镜治疗和手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b098/9537564/4ab48281a4b6/fmed-09-975698-g001.jpg

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