内镜超声检查诊断胃壁外性压迫

ENDOSCOPIC ULTRASONOGRAPHY IN DIAGNOSIS OF EXTRAGASTRIC COMPRESSIONS

为正确判断胃粘膜下隆起性改变是粘膜下肿物还是胃壁外性压迫引起，经超声内镜对６８例胃粘膜下隆起改变进行了检查并作出了正确诊断。其中５３例为正常组织或器官压迫，包括肝脏、脾脏、胆囊、结肠、胰腺、肾脏及血管；１５例为胃外肿物压迫，包括腹腔转移癌、胰头癌、胰体癌、胰尾癌、壶腹癌、肝血管瘤、脾囊肿、腹膜后肿物、胰腺囊肿、结肠癌及肝癌。体外Ｂ超、ＣＴ也对１５例胃外肿物作出了正确诊断，而对其它正常组织或器官壁外性压迫未作出诊断。结果提示内镜超声检查可对胃壁外性压迫隆起作出正确诊断。

A series of 68 cases with extragastric compression underwent endoscopic ultrasonography (EUS) to investigate the cause of that compression. Results and followup studies disclosed that 53 were from nearby normal organs or structures, including liver (16), spleen (16), gallbladder (10), colon (5), pancreas (2), kidney (1) and blood vessels (3). The rest 15 were induced by extraluminal tumors, as carcinomas of pancreatic head (2), body (1) and tail (1), of ampullar Vater (1), of metastasis (2); hepatic hemangioma (1), splenic cysts (2),pancreatic cyst (1), retroperitoneal tumors (2), cancer of colon (1) and of liver (1). All being confirmed by surgery and pathology. B type ultrasonography and computed tomography were also reliable in diagnosing extragastric neogenesis, but failed to show compression from normal organ or structure. It is assumed that EUS is superior to other means in assuring the character of extragastric compression.