牛奶蛋白过敏诱发婴儿胃窦息肉形成2例报告

Gastric antrum polyp formation induced by cow's milk protein allergy in infants:report of two cases

目的 探讨牛奶蛋白过敏与婴儿胃窦息肉的关系.方法 回顾分析2例经电子胃镜和病理组织学检查确诊为胃窦增生性息肉导致胃输出道梗阻患儿的临床资料.结果 男、女患儿各1例,分别为7月龄、11月龄,均表现为反复呕吐,营养不良.2例患儿的腹部超声检查均疑似先天性肥厚性幽门狭窄,其中女性患儿行幽门环肌切开术.2例患儿经无痛胃镜检查发现,胃窦附近息肉样增生导致胃输出道完全梗阻,术中置入空肠管.2例患儿的牛奶特异性IgE分别为0.43 IU/mL、1.35 IU/mL,均经激发试验确诊为牛奶蛋白过敏.2例患儿经持续空肠管喂养氨基酸配方粉,同时口服激素治疗,2个月后复查胃镜,胃窦息肉均明显缩小,并可自行进食.结论 婴儿胃窦息肉少见,2例患儿的胃窦息肉可能与牛奶蛋白过敏相关.

Objective To explore the relationship between cow's milk protein allergy and gastric antrum polyps in infants.Method The clinical data of gastrointestinal obstruction due to gastric antral hyperplastic polyps confirmed by electronic gastroscopy and histopathology in 2 children were retrospectively analyzed.Results One boy and one girl,aged 7 months and 11 months respectively,were presented with repeated vomiting and malnutrition.Both of them were suspected of congenital hypertrophic pyloric stenosis by abdominal ultrasonography and the girl was treated with pyloric ring myotomy.The painless gastroscopy showed that polypoid hyperplasia near the gastric antrum resulted in complete obstruction of the gastric output tract in two children,and jejunal tube was placed during the operation.The cow’s milk specific IgE was 0.43 IU/mL and 1.35 IU/mL respectively in two children,and the milk protein allergy was confirmed by stimulation test.Two children were fed the amino acid formula through the jejunal tube continuously,and were treated with oral hormone therapy at the same time.Two months later,the gastroscopy was reexamined,and the gastric antrum polyps were significantly shrunk,and they could eat by themselves.Conclusion Gastric antrum polyps are rare in infants and may be associated with milk protein allergy in 2 cases.