胃肠道气囊肿内镜下特点的临床分析

Clinical analysis of the endoscopy features of pneumatosis cystoids in gastrointestinal tract

目的通过分析胃肠道气囊肿内镜下表现的特点,提高临床医师的内镜诊断水平。方法回顾性分析北京大学人民医院消化内科2005年1月至2015年5月内镜中心80例诊断为气囊肿患者的临床和内镜资料,包括25例上消化道(胃和十二指肠)气囊肿和55例下消化道(结肠和直肠)气囊肿,对两组患者之间性别、年龄、是否多发以及内镜下特点进行统计学分析。结果将上消化道气囊肿和下消化道气囊肿两组进行比较,性别、年龄、是否多发、表面是否有糜烂两组差异无统计学意义(P>0.05),下消化道气囊肿的直径[(16.93±9.28)mm]显著大于上消化道气囊肿[(9.72±5.36)mm,P=0.001]。上消化道气囊肿多见于十二指肠降部和球部,下消化道气囊肿多见于升结肠和盲肠。气囊肿在内镜下表现为黏膜下透明囊样圆形或椭圆形隆起,超声内镜可以观察到黏膜下气体影,腹部CT可见消化道壁内多发气体影。结论下消化道气囊肿的直径显著大于上消化道气囊肿;上消化道气囊肿多分布于十二指肠降部和十二指肠球部,下消化道气囊肿多分布于升结肠和盲肠。

Objective To describe the clinical and endoscopy features of pneumatosis cystoids in gastrointestinal tract. Methods We retrospectively reviewed the clinical and endoscopic findings in 80 patients who were diagnosed as pneumatosis cystoids in gastrointestinal tract in Peking University People's Hospital between 2005 to 2015, including 25 cases in the upper GI tract and 55 cases in the lower GI tract. We analyzed the gender, age and the endoscopic characteristics. Results Between the two groups of upper GI tract and lower GI tract, the age, gender, the percentage of multiple lesion, the percentage of erosion had no significant difference(P>0.05). The size of pneumatosis of lower GI [(16.93±9.28)mm] was larger than that of upper GI [(9.72±5.36)mm] significantly(P=0.001). The upper GI pneumatosis cystoids were often found in descending part and bulb of duodenum, while the lower GI pneumatosis cystoids in the ascending colon and cecum. The endoscopy findings showed transparent submucosal lesions, while EUS showing the gas in the lesions. The CT scan showed the gas accumulation within the bowel walls. Conclusion The lower GI pneumatosis cystoids, which often found in ascending colon and cecum were larger than the upper GI pneumatosis cystoids often found in duodenum.