Rodriguez-Bigas M A, Penetrante R B, Herrera L, Petrelli N J
Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA.
Gastrointest Endosc. 1995 Dec;42(6):560-4. doi: 10.1016/s0016-5107(95)70011-0.
In familial adenomatous polyposis and juvenile polyposis, polyps can occur throughout the gastrointestinal tract.
We report seven patients with familial adenomatous polyposis and two patients with juvenile polyposis who underwent small bowel enteroscopy at the time of exploratory celiotomy either for colectomy or other pathology.
Polyps in the jejunum and/or ileum were noted in five of nine (56%) patients at enteroscopy. In three of nine (33%) patients these polys were adenomatous. Two of these patients had polyps in the jejunum and in the ileum, whereas one patient had jejunal adenomas alone. These polyps were from 3 mm to 30 mm in size. The remaining two patients with polyps had lymphoid hyperplasia in the ileum. All three patients who had adenomas at intraoperative small bowel enteroscopy had duodenal adenomas at esophagogastroduodenoscopy. At the age of 14 years, one patient had an intramucosal carcinoma in a small bowel juvenile polyp.
Baseline small bowel enteroscopy should be considered at the time of surgical exploration in patients with asymptomatic familial adenomatous polyposis and juvenile polyposis. In patients with duodenal polyps, enteroscopy should be performed at the time of surgery. Biopsy and/or excision of larger polyps should be performed because these polyps may harbor a carcinoma.
在家族性腺瘤性息肉病和幼年性息肉病中，息肉可发生于整个胃肠道。
我们报告了7例家族性腺瘤性息肉病患者和2例幼年性息肉病患者，他们在因结肠切除术或其他病理情况进行剖腹探查时接受了小肠镜检查。
在9例患者中的5例（56%）小肠镜检查时发现空肠和/或回肠有息肉。9例患者中的3例（33%）这些息肉为腺瘤性。其中2例患者空肠和回肠均有息肉，而1例患者仅有空肠腺瘤。这些息肉大小从3毫米到30毫米不等。其余2例有息肉的患者回肠有淋巴组织增生。术中小肠镜检查发现有腺瘤的所有3例患者在食管胃十二指肠镜检查时均有十二指肠腺瘤。1例患者在14岁时，小肠幼年性息肉中有黏膜内癌。
对于无症状的家族性腺瘤性息肉病和幼年性息肉病患者，在手术探查时应考虑进行基线小肠镜检查。对于有十二指肠息肉的患者，手术时应进行小肠镜检查。应切除较大的息肉并进行活检，因为这些息肉可能含有癌。
