家族性肠息肉病恶变1例报告

Familial asenomatous polyposis with canceration:report of one case

目的:探讨家族性肠息肉病(FAP)的临床特点。方法:回顾性分析1例FAP恶变的临床资料。结果:患者因大便习惯改变伴腹胀不适入院。其父死于直肠癌。肛门指检于肛管内可及数十枚息肉,质软,有蒂,退指指套无明显血染。腹盆腔CT检查提示:乙状结肠管壁增厚并周边多发淋巴结显示,考虑占位。肠镜病理结果提示:乙状结肠高级别上皮内瘤变,癌变不除外。考虑为FAP恶变。行乙状结肠癌根治术+全结直肠切除术+末端回肠造瘘术,术后恢复顺利。结论:FAP临床少见,常于青少年期发病,发病初期临床表现缺乏特异性,且恶变倾向明显,早期发现并手术治疗是其关键。

Objective:To identify the clinical features of familial asenomatous polyposis (FAP).Methods:Make a retrospective analyse to one case of FAP with canceration.Results:The patient was admitted to our hospital with frequencies of defecation and abdominal distension.His father died from rectal cancer.Digital rectal examination:There were dozens of polyps in the anal canal,soft texture,pedicled.Abdominal pelvic CT examination showed that the sigmoid colon wall thickened and surrounding lymph nodes were multiple.The case was diagnosed as sigmoid tumor.Pathological examination:(sigmoid colon) high-grade intraepithelial neoplasia,canceration.The patient was diagnosed as FAP with canceration.And later had radical surgery for sigmoid colon cancer,total colorectal resection,and terminal ileostomy,the operation went smoothly.Conclusion:FAP is uncommon in the clinical,and often develops in adolescence.The clinical symptoms are not obvious in the outbreak.The key point of prevention and cure for FAP is earlier detection and surgical treatment due to its malignant tendency.