Fan Z Y, Gong L, Hu W M, Liu W, You Y, Wu D
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Difficult Severe and Rare Diseases, Beijing 100730, China.
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Difficult Severe and Rare Diseases, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2024 Jun 4;104(21):1998-2002. doi: 10.3760/cma.j.cn112137-20240312-00559.
The study aims to summarize the clinical characteristics of patients with ectopic gastric mucosa in the small intestine, comparing clinical presentation differences between domestic and foreign patients through literature review. The clinical characteristics of cases diagnosed with ectopic gastric mucosa in the small intestine at Peking Union Medical College Hospital from January 2000 to January 2024 were retrospectively analyzed. By searching databanks, such as PubMed, EMBASE, the Cochrane Library, Wanfang, VIP, CNKI, and etc (the inclusion period was from the establishment of the database to January 1, 2024). The literature review was conducted on ectopic gastric mucosa in the small intestine. A total of 10 cases were included, all male, age [ (, )] was 27 (13-69) years old. Gastrointestinal bleeding was the first manifestation in most cases, with severe cases leading to hemorrhagic shock. Abdominal CT indicated local intestinal wall thickening and luminal narrowing in 3 cases. Four cases lesions were located at the beginning of the jejunum and 6 lesions were located in the end segment of ileum. All cases underwent local lesion resection, with postoperative pathology confirming ectopic gastric mucosa. Symptoms disappeared postoperatively, with a follow-up period of 0.5-3.0 years. Literature review indicates that the main clinical manifestation of gastric mucosa ectopia in the small intestine in China is gastrointestinal bleeding, while foreign patients are often complicated with intestinal duplication and intussusception, with abdominal pain and vomiting as the primary and main symptoms. The occurrence rate of intestinal obstruction in female patients, both domestically and abroad, is higher than that in male patients. The occurrence rate of ileal lesions with intestinal obstruction and small intestinal duplication is higher than that of duodenal lesions in both domestic and foreign patients. Local small intestine resection is an effective treatment method with generally good prognosis. Ectopic small intestinal mucosa is relatively rare, with symptoms of gastrointestinal bleeding and intestinal obstruction being common presentations, which can serve as one of the differential diagnoses for unexplained gastrointestinal bleeding.
本研究旨在总结小肠异位胃黏膜患者的临床特征，通过文献复习比较国内外患者的临床表现差异。回顾性分析2000年1月至2024年1月在北京协和医院诊断为小肠异位胃黏膜的病例的临床特征。通过检索PubMed、EMBASE、Cochrane图书馆、万方、维普、知网等数据库（纳入期为数据库建立至2024年1月1日）。对小肠异位胃黏膜进行文献复习。共纳入10例，均为男性，年龄[（，）]为27（13 - 69）岁。多数病例以消化道出血为首发表现，严重者导致失血性休克。腹部CT显示3例局部肠壁增厚、管腔狭窄。4例病变位于空肠起始部，6例病变位于回肠末端。所有病例均行局部病变切除，术后病理证实为异位胃黏膜。术后症状消失，随访时间为0.5 - 3.0年。文献复习表明，我国小肠胃黏膜异位的主要临床表现为消化道出血，而国外患者常合并肠重复畸形和肠套叠，以腹痛和呕吐为主要症状。国内外女性患者肠梗阻的发生率均高于男性患者。国内外患者中，肠梗阻和小肠重复畸形的回肠病变发生率高于十二指肠病变。局部小肠切除是一种有效的治疗方法，预后一般良好。异位小肠黏膜相对少见，消化道出血和肠梗阻症状为常见表现，可作为不明原因消化道出血的鉴别诊断之一。
