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胃重复囊肿:1例罕见病例报告

Gastric Duplication Cyst: A Report of a Rare Case.

作者信息

Jayapal Loganathan, Kumar Santhosh, Baskaran Aravind, Balachandar T G, Swain Sudeepta K

机构信息

Gastrointestinal Surgery & Liver Transplantation, Apollo Hospitals, Chennai, IND.

出版信息

Cureus. 2023 Jun 12;15(6):e40285. doi: 10.7759/cureus.40285. eCollection 2023 Jun.

Abstract

Gastric duplication cysts (GDCs) are rare congenital anomalies that primarily occur in childhood but can also manifest in adults. While the ileum is the most common site of duplication, gastric duplications are infrequent. Symptomatic GDCs typically present with upper abdominal pain, vomiting, and occasionally as palpable abdominal masses. Diagnostic imaging, particularly cross-sectional techniques, plays a crucial role in identifying these cysts, and surgical resection is the definitive curative treatment. We report the case of a 44-year-old female who presented with severe right-side upper abdominal pain accompanied by non-bilious vomiting. Initial basic blood investigations yielded normal results. Subsequent contrast-enhanced computed tomography revealed a non-enhancing cystic lesion of size 9x8.5x6.5cm in the left suprarenal region lying posterior to the stomach suggestive of either a GDC or an adrenal cyst. Another hyperdense peripherally enhancing lesion was observed in the right adrenal gland, indicating a right adrenal cyst with internal hemorrhage. During laparotomy, the left side cystic lesion was found arising from the posterior wall of the greater curvature of the stomach, along with another cystic lesion of about 3x3cm originating from the right adrenal gland. Both cystic lesions were successfully excised, and the patient experienced a smooth postoperative recovery without any complications. Histopathological examination confirmed the presence of a cyst lined by gastric-type epithelium with underlying smooth muscle fibers consistent with GDCs. The right adrenal gland cystic lesion exhibited central areas of hemorrhage and necrosis.

摘要

胃重复囊肿(GDCs)是一种罕见的先天性异常,主要发生于儿童期,但也可在成人中出现。虽然回肠是最常见的重复部位,但胃重复并不常见。有症状的GDCs通常表现为上腹部疼痛、呕吐,偶尔可触及腹部肿块。诊断性影像学检查,尤其是横断面技术,在识别这些囊肿方面起着关键作用,手术切除是 definitive curative treatment。我们报告一例44岁女性,她表现为严重的右上腹疼痛并伴有非胆汁性呕吐。最初的基本血液检查结果正常。随后的增强计算机断层扫描显示,在胃后方的左肾上腺区域有一个大小为9×8.5×6.5cm的无强化囊性病变,提示可能是GDC或肾上腺囊肿。在右肾上腺观察到另一个周边强化的高密度病变,提示右肾上腺囊肿伴内部出血。在剖腹手术中,发现左侧囊性病变起源于胃大弯后壁,同时还有一个约3×3cm的囊性病变起源于右肾上腺。两个囊性病变均成功切除,患者术后恢复顺利,无任何并发症。组织病理学检查证实存在一个由胃型上皮衬里且有平滑肌纤维的囊肿,符合GDCs。右肾上腺囊肿性病变表现为中央出血和坏死区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b59/10336738/4f8b1535ae16/cureus-0015-00000040285-i01.jpg

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