5例非典型性异位胰腺内镜分析

Endoscopic analysis of 5 cases of atypical heterotopic pancreas

目的探讨非典型异位胰腺的的临床及内镜特点,以提高临床医师对该病的认识及诊治水平。方法对5例术前误诊,后经术后病理证实为胃肠异位胰腺的患者资料进行回顾性分析,总结5例异位胰腺的内镜、超声内镜及CT下各种特征性表现,分析误诊原因。结果 5例患者在术前分别拟诊为间质瘤、囊肿、胃癌、脂肪瘤、早期胃癌。后经内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)完整切除肿瘤,术后病理均证实为异位胰腺。结论典型异位胰腺的某些特殊类型易与其他病变混淆。只有逐步积累,认真总结、归纳,才能不断提高胃肠异位胰腺的诊断水平。

Objective To investigate the clinical data and endoscopic analysis of atypical heterotopic pancreas, and improve the ability and the diagnosis and treatment of the disease. Methods Data of 5 patients with gastric heterotopic pancreas diagnosed by postoperative pathology were collected, including endoscopic, endoscopic ultrasonography and CT manifestations. Results Five cases were diagnosed as gastric stromal tumor, cysts, gastric cancer, and early gastric cancer respectively before the operation, and then all 5 cases were confirmed as heterotopic pancreas based on postopera- tive pathological by endoscopic submucosal dissection （ESD）. Conclusion Some special types of typical heterotopic pancreas are likely to be confused with other submucosal lesions. Only when we get gradually accumulation, summary, and induction, can we improve the diagnosis of gastrointestinal heterotopic pancreas.