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内镜下切除十二指肠脂肪瘤作为上消化道出血的罕见原因:一例报告

Endoscopically resected duodenal lipoma as an uncommon cause of upper gastrointestinal bleeding: a case report.

作者信息

Joo Dong Chan, Kim Gwang Ha, Lee Bong Eun, Lee Moon Won, Kim Cheolung

机构信息

Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea.

出版信息

Ewha Med J. 2024 Jan;47(1):e8. doi: 10.12771/emj.2024.e8. Epub 2024 Jan 31.

DOI:10.12771/emj.2024.e8
PMID:40703392
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12093541/
Abstract

Subepithelial tumors in the upper gastrointestinal (GI) tract are often detected during nationwide endoscopic gastric cancer screening in Korea. Most GI lipomas are asymptomatic and do not necessitate further treatment. However, large tumors may lead to complications such as bowel obstruction, intussusception, and bleeding. These GI lipomas require endoscopic or surgical resection. On radiological examination, GI lipomas typically manifest as hypodense lesions with similar density to that of fat tissue. White-light endoscopy generally reveals a yellowish subepithelial tumor exhibiting a positive cushion sign, while endoscopic ultrasonography shows a homogeneous hypoechoic mass within the third layer of the GI tract. We present the case of an 81-year-old woman with symptomatic duodenal lipoma following endoscopic resection.

摘要

韩国全国性的内镜胃癌筛查中经常会发现上消化道(GI)的上皮下肿瘤。大多数胃肠道脂肪瘤无症状,无需进一步治疗。然而,大的肿瘤可能会导致肠梗阻、肠套叠和出血等并发症。这些胃肠道脂肪瘤需要内镜或手术切除。在影像学检查中,胃肠道脂肪瘤通常表现为密度低于周围组织的病变,其密度与脂肪组织相似。白光内镜检查一般显示为黄色的上皮下肿瘤,有阳性垫征,而内镜超声检查显示在胃肠道第三层内有均匀的低回声肿块。我们报告一例81岁有症状的十二指肠脂肪瘤患者经内镜切除后的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/d34678f4274f/emj-47-1-8-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/c1687594324e/emj-47-1-8-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/0af0e189b7aa/emj-47-1-8-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/1593b0fc00ae/emj-47-1-8-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/d34678f4274f/emj-47-1-8-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/c1687594324e/emj-47-1-8-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/0af0e189b7aa/emj-47-1-8-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/1593b0fc00ae/emj-47-1-8-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37c0/12093541/d34678f4274f/emj-47-1-8-g4.jpg

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本文引用的文献

1
Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study.韩国上消化道上皮下病变的患病率、自然进展及临床实践:一项多中心研究
Clin Endosc. 2023 Nov;56(6):744-753. doi: 10.5946/ce.2023.005. Epub 2023 Aug 25.
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Giant duodenal lipoma: an unusual cause of gastrointestinal bleeding (a case report).巨大十二指肠脂肪瘤:胃肠道出血的不常见病因(病例报告)。
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A Case of a Bleeding Duodenal Lipoma Successfully Controlled by Endoscopic Resection.
一例十二指肠脂肪瘤出血经内镜切除成功控制的病例。
Clin Endosc. 2020 Mar;53(2):236-240. doi: 10.5946/ce.2019.035. Epub 2019 Jul 24.
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Int J Surg Case Rep. 2018;51:313-317. doi: 10.1016/j.ijscr.2018.08.061. Epub 2018 Sep 9.
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En bloc resection of a large symptomatic duodenal lipoma by endoscopic submucosal dissection.通过内镜下黏膜下剥离术整块切除巨大有症状十二指肠脂肪瘤。
VideoGIE. 2017 Apr 20;2(7):182-184. doi: 10.1016/j.vgie.2017.03.003. eCollection 2017 Jul.
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Diagnosis and Treatment of Duodenal Lipoma: A Systematic Review and a Case Report.十二指肠脂肪瘤的诊断与治疗:一项系统综述及病例报告
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Systematic review of giant gastric lipomas reported since 1980 and report of two new cases in a review of 117110 esophagogastroduodenoscopies.系统回顾自 1980 年以来报告的巨大胃脂肪瘤,并在对 117110 例食管胃十二指肠镜检查的回顾中报告 2 例新病例。
World J Gastroenterol. 2017 Aug 14;23(30):5619-5633. doi: 10.3748/wjg.v23.i30.5619.
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Duodenal Lipoma as a Rare Cause of Upper Gastrointestinal Bleeding.十二指肠脂肪瘤作为上消化道出血的罕见原因。
Gastroenterology Res. 2010 Dec;3(6):290-292. doi: 10.4021/gr260w. Epub 2010 Nov 20.
9
Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions.内镜超声检查在胃上皮下病变诊断中的应用
Clin Endosc. 2016 Sep;49(5):425-433. doi: 10.5946/ce.2016.065. Epub 2016 Sep 5.
10
CT manifestations of lipomas of the small intestine and colon.
Clin Imaging. 1993 Jul-Sep;17(3):179-82. doi: 10.1016/0899-7071(93)90105-v.