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胃贲门平滑肌瘤合并大量胃肠道出血:1例罕见病例报告。

Gastric cardiac leiomyoma complicated with massive gastrointestinal bleeding: A rare case report.

作者信息

Liu Zhaohui, Lei Yaru, Sun Dayong, Wu Ruinuan

机构信息

The Department of Gastroenterology, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.

Department of Medicine, Shenzhen University, Shenzhen, China.

出版信息

Medicine (Baltimore). 2025 Jul 4;104(27):e43119. doi: 10.1097/MD.0000000000043119.

Abstract

RATIONALE

We report a rare case of gastric cardiac leiomyoma with massive gastrointestinal bleeding as the first symptom that presented. This is the first case of this rare condition occurring in a patient younger than 20 years old. Positive results could not be obtained by routine biopsy, and the diagnosis was finally confirmed by endoscopic ultrasound-guided fine-needle aspiration biopsy.

PATIENT CONCERNS

A man aged less than 20 years old presented to the emergency department of the hospital due to upper gastrointestinal bleeding for 2 days.

DIAGNOSES

Emergency gastroscopy revealed that a bulging mass could be seen at the gastric cardia. Computed tomography revealed a large hypoechoic mass in the cardia of the fundus without enhancement. Finally, endoscopic ultrasound-guided fine-needle aspiration biopsy was performed. The pathological diagnosis was a leiomyoma.

INTERVENTIONS

The patient ultimately opted for total gastrectomy.

OUTCOMES

The patient's gastric cardiac leiomyoma was completely resolved, and no digestive tract symptoms recurred after 1 month of follow-up.

LESSONS

For young patients with upper gastrointestinal bleeding, we should also be aware of the possibility of other rare causes. Endoscopic ultrasound-guided fine-needle aspiration is very valuable for the diagnosis of submucosal tumors.

摘要

原理

我们报告了一例罕见的胃贲门平滑肌瘤,以大量胃肠道出血为首发症状。这是该罕见病症在一名20岁以下患者中发生的首例病例。常规活检未能获得阳性结果,最终通过内镜超声引导下细针穿刺活检确诊。

患者情况

一名不到20岁的男性因上消化道出血2天到医院急诊科就诊。

诊断

急诊胃镜检查显示胃贲门处可见一隆起性肿物。计算机断层扫描显示胃底贲门处有一较大的低回声肿物,无强化。最终进行了内镜超声引导下细针穿刺活检。病理诊断为平滑肌瘤。

干预措施

患者最终选择了全胃切除术。

结果

患者的胃贲门平滑肌瘤完全消除,随访1个月后无消化道症状复发。

经验教训

对于年轻的上消化道出血患者,我们也应意识到其他罕见病因的可能性。内镜超声引导下细针穿刺对黏膜下肿瘤的诊断非常有价值。

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