超声内镜对十二指肠降部隆起病变的诊断价值

Clinical value of endoscopic ultrasonography on diagnosis of descendant duodenum protrude lesions

[目的]探讨十二指肠降部隆起病变的超声内镜诊断价值。[方法]对43例患者的51个十二指肠降部隆起病变行超声内镜检查,判断其病变层次、范围、超声特点,确立诊断;根据不同病变选择内镜下结扎治疗或电切除术,部分病例经手术或病理证实。[结果]51个十二指肠降部隆起病变中,间质瘤16个,平滑肌瘤2个,囊肿24个,囊性淋巴管瘤1个,脂肪瘤3个,血管瘤2个,副乳2个,先天性胆总管囊肿1个,超声内镜的诊断符合率为94.1%(48/51)。根据不同的病变选择结扎治疗或内镜下电切除术,2例副乳及1例先天性胆总管囊肿未行处理,3个月至半年后复查见原病变处已形成瘢痕。[结论]十二指肠降部隆起病变以间质瘤和囊肿多见,在超声内镜指导下的结扎或电切除术对十二指肠降部隆起病变有良好的治疗作用。

[Objective]To evaluate the usefulness of endoscopic ultrasonography（EUS）on the judgment of descendant duodenum protrude lesions.[Methods]Fifty-one lesions in 43 patients were examined by EUS,the depth,range and ultrasound feature of lesion were investigated.Accordingly,the lesions were treated by endoscopic ligation or resection was used.Part of the lesions were confirmed by pathologic diagnosis.[Results]Among the 51 lesions,16 were diagnosed ultrasonographally as gastrointestinal stromal tumor（GIST）,2were leiomyoma,24 were cyst,1was cystic lymphangioma,3were adipoma,2were angioma,2were minor duodenal papilla,1was congenital choledochocyst.They were treated by endoscopic ligation or resection,2minor duodenal papillas and 1congenital choledochocyst weren＇t treated.Followed endoscopic examination was performed in the patients underwent endoscopic therapy three months to half a year later and showed that all the lesions were removed and scar could be observed.The coincidence rate of EUS in the diagnosis of duodenal descending of apophysis lesions was 94.1%（48/51）.[Conclusion]GIST and cyst were the major causes of protrude lesion at duodenal descending part.With the guidance of EUS,endoscopic ligation or resection can treat the lesions appropriately.