Haddad V, Macon W L, Islami M H
Surg Gynecol Obstet. 1981 Feb;152(2):227-33.
Fifty-six adult patients with antral mucosal diaphragms have been reported in the literature. These abnormalities are located at the antrum of the stomach at variable distances from the pylorus and are composed of mucosa which encloses a membrane of submucosa without involvement of muscularis or serosa. They may be congenital in origin or secondary to chronic peptic ulcer disease. Symptoms are episodic and obstructive in nature and imply a diaphragmatic aperture of less than 1 centimeter. The diagnosis relies on the history, contrast roentgenologic studies and endoscopic findings. Unfortunately, the changes observed are many times either overlooked or misinterpreted and, not infrequently, the diagnosis will be made at laparotomy by gastrotomy. Surgical treatment is uniformly successful in symptomatic patients and is recommended for patients who have obstructive symptoms. The surgical procedures have been variable but as long as the obstruction is alleviated, it appears that there is no preference for one particular operation. When complicated with ulcer disease, a complementary ulcer operation is recommended. Antral diaphragm, although rare, should be considered in the differential diagnosis of upper gastrointestinal obstructive symptoms in patients of any age.
文献中已报道了56例患有胃窦黏膜隔膜的成年患者。这些异常位于胃窦，距幽门的距离各不相同，由包绕黏膜下膜的黏膜组成，不累及肌层或浆膜。它们可能是先天性的，也可能继发于慢性消化性溃疡病。症状呈发作性且具有梗阻性，提示隔膜孔径小于1厘米。诊断依赖于病史、对比X线造影检查和内镜检查结果。不幸的是，观察到的变化很多时候要么被忽视要么被误解，而且经常在剖腹手术时通过胃切开术才能做出诊断。手术治疗对有症状的患者均获成功，推荐用于有梗阻症状的患者。手术方式各不相同，但只要梗阻得到缓解，似乎对某一种特定手术并无偏好。当合并溃疡病时，推荐进行补充性溃疡手术。胃窦隔膜虽然罕见，但在任何年龄患者的上消化道梗阻症状鉴别诊断中都应予以考虑。
