十二指肠球部胃黏膜异位的内镜与病理特点

Endoscopy of heterotopic gastric mucosa in duodenal bulb and its pathologic features

目的探讨十二指肠球部胃黏膜异位的内镜与病理特点。方法回顾性分析2003年10月-2012年10月在我院经病理证实的102例十二指肠球部胃黏膜异位的患者临床、内镜资料。结果异位病灶位于球腔前壁较多见,根据内镜下表现可分为三型,颗粒样增生35例,平坦隆起型20例,息肉样增生47例。病理提示固有层可见胃体腺,部分可见胃底腺及幽门腺。结论内镜下分型以息肉样增生最多见,单纯内镜诊断符合率低,组织病理学检查是确诊本病的主要手段。

Objective To study the endoscopy of heterotopic gastric mucosa in duodenal bulb and its pathologic features.Methods Clinical and endoscopic data about 102 patients with pathology-confirmed heterotopic gastric mucosa in duodenal bulb admitted to our hospital from October 2003 to October 2012 were retrospectively analyzed.Results The heterotopic foci were usually located on the anterior wall of duodenal bulb and could be divided into granular hyperplasia type（in 35 patients）,flat elevated type（in 20 patients） and polypoid hyperplasia type（in 47 patients） according to their endoscopic findings.Pathological examination showed gastric body glands,fundic glands or pyloric glands in the lamina propria.Conclusion Polypoid hyperplasia is the most common type of heterotopic gastric mucosa in duodenal bulb with a low diagnostic accuracy of endoscopy.Histopathology plays an important role in its diagnosis.