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内镜黏膜下剥离联合手术治疗胃固有肌层和浆膜层异位胃黏膜及异位胰腺:1例罕见病例报告并文献复习

Endoscopic submucosal dissection combined surgery for the treatment of ectopic gastric mucosa and ectopic pancreas in muscularis propria and serosal layer of the stomach: A rare case report and review of the literature.

作者信息

Chen Yindi, Cao Yanbing, Zhi Lingran, Huang Rui

机构信息

Department of Gastroenterology, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi Province, China.

Department of General Surgery, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi Province, China.

出版信息

Medicine (Baltimore). 2025 Feb 28;104(9):e41297. doi: 10.1097/MD.0000000000041297.

Abstract

RATIONALE

Ectopic gastric mucosa (EGM) and ectopic pancreas (EP) in the stomach is a rare congenital anomaly. No research on the coexistence of EGM and EP in the stomach has been found. However, several studies have shown canceration of EGM outside the stomach and EP. Active surgical treatment may be necessary. This paper introduces a new case of ectopic gastric mucosa and ectopic pancreas in muscularis propria and serosal layer of the stomach and which were ultimately removed by endoscopic submucosal dissection combined surgery.

PATIENT CONCERNS

The patient was a 25-year-old male. Upper gastrointestinal endoscopy showed a subepithelial lesion in gastric antrum.

DIAGNOSES

Postoperative pathology confirmed a diagnosis of EGM and EP.

INTERVENTIONS

Enhanced computed tomography scan and endoscopic ultrasonography showed a submucosal tumor. Then endoscopic submucosal dissection was performed, during which a lesion was observed on the anterior wall of the stomach near the pylorus. This lesion invades the muscularis propria of the stomach and the large lesions near the pylorus may lead to pyloric obstruction. Considering these situations comprehensively, the patient ultimately underwent surgical resection of gastric lesion and partial gastrectomy.

OUTCOMES

After 3 months of follow-up, the patient was recovering well and no recurrence of the lesion was found so far.

LESSONS

EGM along with EP in the stomach is a rare condition. Due to its rarity, there was a lack of sufficient data support for its treatment and prognosis. Due to the EGM and EP may become cancerous, clinical attention should be paid to it. In this study, we present a new case report of EGM along with EP in the stomach and review the existing literature to explore treatment options for it.

摘要

理论依据

胃内异位胃黏膜(EGM)和异位胰腺(EP)是一种罕见的先天性异常。尚未发现有关胃内EGM和EP共存的研究。然而,多项研究表明胃外EGM和EP会发生癌变。可能需要积极的手术治疗。本文介绍了一例胃固有肌层和浆膜层存在异位胃黏膜和异位胰腺的新病例,最终通过内镜黏膜下剥离术联合手术将其切除。

患者情况

患者为一名25岁男性。上消化道内镜检查显示胃窦有一个上皮下病变。

诊断

术后病理证实为EGM和EP。

干预措施

增强计算机断层扫描和内镜超声检查显示为黏膜下肿瘤。随后进行了内镜黏膜下剥离术,在此过程中,在靠近幽门的胃前壁观察到一个病变。该病变侵犯胃固有肌层,且靠近幽门的大病变可能导致幽门梗阻。综合考虑这些情况,患者最终接受了胃病变手术切除及部分胃切除术。

结果

经过3个月的随访,患者恢复良好,目前未发现病变复发。

经验教训

胃内EGM合并EP是一种罕见情况。由于其罕见性,缺乏足够的数据支持其治疗和预后。由于EGM和EP可能癌变,临床应予以关注。在本研究中,我们报告了一例胃内EGM合并EP的新病例,并回顾现有文献以探索其治疗方案。

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