Will U, Masri R, Bosseckert H, Knopke A, Schönlebe J, Justus J
Dept of Internal Medicine I, University of Jena, Germany.
Endoscopy. 1998 May;30(4):432-5. doi: 10.1055/s-2007-1001297.
Abscesses in the gastric wall are extremely rare. As the mucosa remains intact in most cases, clear differential diagnosis is required in order to distinguish the condition from the more frequent intramural mesenchymal tumors. Endoscopic ultrasonography provides a valuable tool for imaging intramural tumors, but this approach does not allow a definitive assessment of malignancy. We report about two patients with intramural abscesses in the gastric wall. Endosonography showing eccentric tumors from the gastric wall in the two patients. The endosonographic image was inhomogenous, the wall layer structure of the gastric wall was not preserved. A laparotomy was carried out on the first patient. In the second case, the diagnosis was easy, as pus was emptying from a small opening in the mucosa, which had already been detected at gastroscopy. Endoscopic intervention was carried out based on the endosonographic findings. In one patient, mucosa and submucosa were opened by a needle knife. These cases show that gastric wall abscesses do not have a typical endoscopic ultrasound appearance. However, endosonography is an essential method prior to endoscopic interventional therapy.
胃壁脓肿极为罕见。由于在大多数情况下黏膜保持完整，因此需要进行明确的鉴别诊断，以便将该病症与更常见的壁间间叶组织肿瘤区分开来。内镜超声检查为壁内肿瘤成像提供了一种有价值的工具，但这种方法无法对恶性肿瘤进行明确评估。我们报告了两例胃壁壁内脓肿患者。内镜超声检查显示这两名患者胃壁有偏心性肿瘤。内镜超声图像不均匀，胃壁的壁层结构未保留。对首例患者进行了剖腹手术。在第二例中，诊断很容易，因为脓液从黏膜上的一个小孔排出，该小孔在胃镜检查时已被发现。基于内镜超声检查结果进行了内镜干预。在一名患者中，用针刀切开了黏膜和黏膜下层。这些病例表明，胃壁脓肿没有典型的内镜超声表现。然而，内镜超声检查是内镜介入治疗前的必要方法。
