15例十二指肠Brunner腺瘤的诊治

Analysis on clinical features of duodenal Brunner's gland adenoma

目的研究十二指肠Brunner腺瘤的临床特征和诊治进展。方法总结分析15例十二指肠Brunner腺瘤患者的临床表现、血清学检测、X线钡餐造影、普通内镜、超声内镜检查和治疗结果。将部分接受超声内镜检查者的诊断结果与术后组织病理检查结果进行对比。结果15例患者中有症状和体征者8例,其中伴发溃疡4例(溃疡并发穿孔2例),并发上消化道出血4例。所有患者血清学检查无异常；接受X线钡餐造影6例,内镜检查13例,诊断十二指肠Brunner腺瘤仅2例；超声内镜检查8例,均诊断为十二指肠Brunner腺瘤。15例患者中采用外科手术治疗7例,内镜摘除治疗8例,术前超声内镜检查结果与术后组织病理学诊断一致。结论十二指肠Brunner腺瘤是一种良性肿瘤,临床表现缺乏特异性,超声内镜检查对该病的诊治有一定价值,外科手术或内镜下摘除是主要的治疗方法。

Objective To investigate the clinical features, diagnostic modalities and treatment of duodenal Brunner＇ gland adenoma（BGA）. Methods Fifteen patients with duodenal BGA were evaluated base on clinical presentations, the results of serologic test, barium meal examination, gastroscopy and endoscopic ultrasonography（EUS） as well as treatment. The post-operative histological results were compared with pre-operation EUS findings. Results Eight out of 15 patients with duodenal BGA had presentations, including duodenal ulcer （4 patients）, upper gastrointestinal hemorrhage （4 patients）. The serologic tests of all patients were within the normal limits. Six patients underwent barium meal examination and 13 patients received gastroscopy. Seven patients underwent surgical treatment and 8 patients received endoscopic resection. The post-operative histological results were compatible with the pre-operative EUS findings. Conclusions Duodenal BGA is a benign tumor. EUS was helpful in making the diagnosis and determination of treatment methods （surgical operation or endoscopic resection）.