消化内镜对小肠淋巴管瘤的诊断价值

Diagnostic values of digestive endoscopy in small intestinal lymphangioma

目的探讨小肠淋巴管瘤(LA)的临床表现、病变分布、消化内镜特点及其对小肠LA的诊断价值。方法本文回顾性分析59例小肠LA患者临床资料(青岛大学附属医院诊断的2例及检索国内外文献57例)。结果临床表现主要为消化道出血31(52.5%)、贫血25(42.4%)和腹痛25(42.4%)。病变分布:空肠相对多见。消化道内镜检查:胶囊内镜检查21例,14例发现病变,1例通过镜下特点疑诊;小肠镜检查24例,23例发现病变,其中12例初步诊断。13例患者均进行了胶囊内镜及小肠镜检查,内镜下病变发现率,小肠镜优于胶囊内镜(P<0.05);内镜下初步诊断率:小肠镜优于胶囊内镜(P<0.05)。结论小肠LA非常罕见,消化道出血、贫血及腹痛为其常见临床表现,病变分布以空肠多发,胶囊内镜具有良好的病变定位功能,小肠镜对于发现病变及初步诊断小肠LA具有重要价值。

Objective To investigate the characteristics and distributions of the small intestinal lymphangioma（ LA） and the diagnosis values of digestive endoscopy in it. Methods Data of 59 patients with small intestinal lymphangioma between 1999 and 2016 were retrospectively studied. Results The main clinical manifestations were gastrointestinal bleeding（ 52. 5%）,anemia（ 42. 4%） and abdominal pain（42. 4%）. Small intestinal lymphangioma mostly occurred in jejunum. Fourteen out of 21 patients were found lesions under capsule endoscopic examination,one of which was suspicious of LA. Twenty-four patients underwent enteroscopic examination,23 of which were found lesions,and 12 of which were suspicious of LA.There were 13 cases who underwent both capsule endoscopic examination and small intestinal endoscopic examination. Both the detective and diagnostic rates of enteroscopic examination were higher than those of capsule endoscopic examination（ P〈0. 05）. Conclusions Clinical manifestations of intestinal LA were commonly gastrointestinal bleeding,anemia and abdominal pain. Small intestinal LA was more commonly found in colon. Capsule endoscopy has a good function of localization. Enteroscopy is valuable for detecting and diagnosing small intestinal LA.