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胃黏膜异位导致的复发性小肠穿孔:一例报告

Recurrent small intestinal perforation from gastric mucosal heterotopia: A case report.

作者信息

Li Zhi-Wang, Jiang Tao-Feng, Yang Cheng-Kun, Xu Zhi-Jie, Zhu Wen-Biao, Li En

机构信息

Department of Gastrointestinal Surgery, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.

Department of Gastroenterology, Meizhou People's Hospital, Meizhou 514031, Guangdong Province, China.

出版信息

World J Gastrointest Surg. 2024 Dec 27;16(12):3857-3861. doi: 10.4240/wjgs.v16.i12.3857.

Abstract

BACKGROUND

Gastric mucosal heterotopia (GMH) is a rare, typically asymptomatic condition characterized by ectopic gastric mucosa in tissues outside the stomach. However, it can lead to severe complications, including small intestinal perforation. This case report highlights the unique clinical presentation of GMH-induced recurrent small intestinal perforations, which has been rarely documented. These findings emphasize the importance of considering GMH in patients with unexplained recurrent gastrointestinal perforations.

CASE SUMMARY

A 13-year-old female presented with acute abdominal pain. Her medical history included four prior surgeries for small intestinal perforations. Enhanced computed tomography revealed localized bowel thickening and perforation, prompting emergency surgery. A 20 cm segment of the ileum was resected and anastomosed. Pathological analysis confirmed extensive GMH with ulceration and perforation, identifying GMH as the cause of the recurrent perforations. Postoperatively, the patient recovered well with no recurrence by the 10-month follow-up.

CONCLUSION

GMH should be considered in cases of recurrent unexplained intestinal perforations.

摘要

背景

胃黏膜异位(GMH)是一种罕见的、通常无症状的疾病,其特征是胃外组织中出现异位胃黏膜。然而,它可导致严重并发症,包括小肠穿孔。本病例报告突出了GMH引起的复发性小肠穿孔的独特临床表现,这种情况鲜有记录。这些发现强调了在不明原因复发性胃肠道穿孔患者中考虑GMH的重要性。

病例摘要

一名13岁女性因急性腹痛就诊。她的病史包括此前因小肠穿孔进行的四次手术。增强计算机断层扫描显示局部肠壁增厚和穿孔,遂进行急诊手术。切除并吻合了一段20厘米长的回肠。病理分析证实存在广泛的胃黏膜异位伴溃疡和穿孔,确定胃黏膜异位是复发性穿孔的原因。术后,患者恢复良好,随访10个月无复发。

结论

对于不明原因的复发性肠穿孔病例,应考虑胃黏膜异位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d639/11650218/b34f7469f56a/WJGS-16-3857-g001.jpg

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