Grischkan D, Brown L, Mazansky H, Archer B, Price F, Al-Rifai T
Can J Surg. 1982 Mar;25(2):213-5.
A 64-year-old woman presented with atypical abdominal pain, weight loss, melena and hematemesis. Reactivation of a peptic ulcer was diagnosed and she was treated with antacids and cimetidine. When her symptoms recurred 4 months later, a perforated duodenal ulcer was noted on roentgenograms. At laparotomy this proved to be a perforated, localized lymphoma of the duodenum. This case highlights an important consideration in the management of duodenal ulcers. Patients who present with a previously diagnosed peptic ulcer, who demonstrate atypical symptoms and remain refractory to treatment should undergo endoscopic examination and biopsy to rule out an occult localized duodenal lymphoma.
一名64岁女性出现非典型腹痛、体重减轻、黑便和呕血症状。诊断为消化性溃疡复发，给予抗酸剂和西咪替丁治疗。4个月后症状复发时，X线片显示十二指肠溃疡穿孔。剖腹手术时发现这是一例十二指肠穿孔性局限性淋巴瘤。该病例凸显了十二指肠溃疡治疗中的一个重要考量因素。对于先前诊断为消化性溃疡、出现非典型症状且治疗无效的患者，应进行内镜检查和活检以排除隐匿性局限性十二指肠淋巴瘤。
