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使用管腔贴附金属支架进行内镜超声引导下结直肠腔外黏液囊肿引流：一种新方法。

Endoscopic Ultrasound-Guided Drainage of Extraluminal Colorectal Mucocele Using A Lumen-Apposing Metal Stent: A Novel Approach.

作者信息

Njeim Ryan, Moussa Elie, Habib Toni, Abureesh Omar, Yasin Saif, Kalta Daniel, El Douaihy Youssef

机构信息

Department of Internal Medicine, Staten Island University Hospital - Northwell Health, Staten Island, USA.

Department of Gastroenterology, Staten Island University Hospital - Northwell Health, Staten Island, USA.

出版信息

Eur J Case Rep Intern Med. 2025 Aug 19;12(9):005703. doi: 10.12890/2025_005703. eCollection 2025.

DOI:10.12890/2025_005703
PMID:40927780
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12416772/
Abstract

UNLABELLED

Colorectal mucoceles are rare mucinous cysts arising in the gastrointestinal tract and presenting diagnostic and therapeutic challenges. We report the first successful treatment of an extraluminal colorectal mucocele using a lumen-apposing metal stent (LAMS). A 65-year-old male with a known medical history of diverticulitis treated with a partial colectomy presented with constipation and low back pain. Computed tomography scan (CT) revealed a 5.4 cm cystic structure adjacent to the rectal anastomosis. Endoscopic ultrasound (EUS) found a subepithelial lesion with an "onion peel" appearance, and aspiration cytology confirmed a colo-colonic mucocele. Management consisted of EUS-guided placement of an 8 × 8 mm LAMS, allowing for drainage, irrigation, and suctioning of the cavity. Complete resolution was achieved without recurrence over a 2-year follow-up period. This case demonstrates the potential of advanced endoscopic techniques, particularly LAMS, in managing extraluminal colorectal mucoceles. While further research is needed to compare the efficacy of LAMS with other treatment modalities, this procedure offers a minimally invasive alternative to surgery for certain patients.

LEARNING POINTS

Novel approach to treat a rare case of colorectal mucocele using a lumen-apposing metal stent.

摘要

未标注

结直肠黏液囊肿是发生在胃肠道的罕见黏液性囊肿，在诊断和治疗上具有挑战性。我们报告了首例使用管腔贴附金属支架（LAMS）成功治疗腔外结直肠黏液囊肿的病例。一名65岁男性，有憩室炎病史并接受了部分结肠切除术，出现便秘和腰痛。计算机断层扫描（CT）显示直肠吻合口旁有一个5.4厘米的囊性结构。内镜超声（EUS）发现一个具有“洋葱皮”外观的上皮下病变，抽吸细胞学检查证实为结肠结肠黏液囊肿。治疗方法包括在EUS引导下放置一个8×8毫米的LAMS，以便对囊肿进行引流、冲洗和抽吸。在2年的随访期内囊肿完全消退且无复发。该病例证明了先进内镜技术，特别是LAMS，在治疗腔外结直肠黏液囊肿方面的潜力。虽然需要进一步研究来比较LAMS与其他治疗方式的疗效，但该手术为某些患者提供了一种微创的手术替代方案。

学习要点

使用管腔贴附金属支架治疗罕见结直肠黏液囊肿的新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/069a685777f1/5703_Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/98dbba000e9a/5703_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/911da535eb92/5703_Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/716568082952/5703_Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/069a685777f1/5703_Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/98dbba000e9a/5703_Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/911da535eb92/5703_Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/716568082952/5703_Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4524/12416772/069a685777f1/5703_Fig4.jpg

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本文引用的文献

1
Endosonographic Diagnosis of Rectal Mucocele: The "Onion Skin" Sign.直肠黏液囊肿的内镜超声诊断：“洋葱皮”征
ACG Case Rep J. 2022 Jul 1;9(7):e00813. doi: 10.14309/crj.0000000000000813. eCollection 2022 Jul.
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Rectal stump mucocele after a Hartmann's procedure causing mechanical ileus.经肛直肠残端黏液囊肿导致机械性肠梗阻的 Hartmann 术后。
BMJ Case Rep. 2021 Jan 8;14(1):e237543. doi: 10.1136/bcr-2020-237543.
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Alternative uses of lumen apposing metal stents. lumen 贴合金属支架的其他用途。
World J Gastroenterol. 2020 Jun 7;26(21):2715-2728. doi: 10.3748/wjg.v26.i21.2715.
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Giant Symptomatic Rectal Mucocele following Subtotal Colectomy.全结肠切除术后巨大症状性直肠黏液囊肿
Case Rep Gastroenterol. 2018 Apr 20;12(1):143-146. doi: 10.1159/000488523. eCollection 2018 Jan-Apr.
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Rectal mucocele in the anterior wall of the rectum.直肠前壁的直肠黏液囊肿。
BMJ Case Rep. 2018 May 18;2018:bcr-2018-225097. doi: 10.1136/bcr-2018-225097.
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