Dailianas A, Spiliadis C, Skandalis N, Rimikis M, Manika Z
Department of Gastroenterology, General Hospital of Athens, Greece.
Ital J Gastroenterol. 1994 Sep;26(7):357-9.
A 76-year-old man with an iron deficiency anemia during the previous 4 years and recent melena was presented. Gastroscopy showed a sessile polypoid lesion in the area of the papilla of Vater and histology was normal. Barium swallow follow-through and CT scan revealed a round intraluminal filling defect. ERCP demonstrated extrinsic compression of both ducts. Emergency laparotomy was performed because of upper GI bleeding and because attempts at endoscopic haemostasis of the oozing polypoid mass were unsuccessful. A soft compressible polypoid mass was found, which on palpation excreted a viscous milky liquid through a tiny opening. Histology showed normal duodenal mucosa bilaterally, a diagnostic finding of intraluminal duodenal diverticulum. The atypical age of presentation as well as gastroscopic and roentgenographic findings of this rare entity are illustrated.
一名76岁男性，在过去4年中患有缺铁性贫血，近期出现黑便。胃镜检查显示在十二指肠乳头区域有一个无蒂息肉样病变，组织学检查正常。钡餐造影和CT扫描显示管腔内有一个圆形充盈缺损。内镜逆行胰胆管造影（ERCP）显示两条导管均有外部压迫。由于上消化道出血，且对息肉样肿物渗血进行内镜止血的尝试未成功，遂进行了急诊剖腹手术。发现一个柔软可压缩的息肉样肿物，触诊时通过一个小孔排出粘性乳白色液体。组织学检查显示双侧十二指肠黏膜正常，这是腔内十二指肠憩室的诊断性发现。文中展示了这种罕见疾病的非典型发病年龄以及胃镜和X线检查结果。
