This study explored the clinical value of endoscopic ligation for the treatment of upper gastrointestinal(GI)protuberant lesions in children.According to the appearance and size of lesions,we used different ligation t...This study explored the clinical value of endoscopic ligation for the treatment of upper gastrointestinal(GI)protuberant lesions in children.According to the appearance and size of lesions,we used different ligation techniques for the treatment of the lesions.Endoscopic ultrasonography was used for preliminary characterization of the lesions.One case diagnosed with PeutzJeghers syndrome was successfully treated by a detachable snare.Two cases with semi-pedunculated or broad-base lesions originating from the submucosal layer of the upper GI were treated with endoscopic variceal ligation;endoscopic examination showed that one case had complete healing 11 wk after ligation,while an ulcer scar was observed at the ligation site after 6 wk in the other case.All lesions were successfully ligated at the first attempt.No significant complications occurred either during or after the procedure.Selective endoscopic ligation of upper GI lesions is an effective and safe treatment for upper GI protuberant lesions in children.展开更多
Objective： The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography （CT） and conventional endoscope etc. Thus, we investigated the cl...Objective： The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography （CT） and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography （PUS） with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods： Patients with duodenal protruding lesions who were indicated for PUS were examined by PUS with 12-15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of PUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of PUS. Those patients without endoscopic resection or surgical excision were periodically followed up with PUS. Results： A total of 169 patients with duodenal protruding lesions were examined by PUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner＇s gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After PUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of PUS, with 93.33% diagnostic accuracy. The results of follow-up with PUS indicated that duodenal cyst, Brunner＇s gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1-3 years. No related complications occurred among all patients that received PUS examinations. Conclusion： PUS is an effective and reliable diagnostic method for duodenal protruding lesions.展开更多
目的:探讨胆囊小隆起性病变(small apophysis disease of the gallbladder,SADG)的临床病理学特点与超声诊断中的相关性.方法:采用彩色多普勒超声检查的SADG患者753例,并经手术病理证实,对比研究诊断结果,回顾性分析SADG的临床病理特点...目的:探讨胆囊小隆起性病变(small apophysis disease of the gallbladder,SADG)的临床病理学特点与超声诊断中的相关性.方法:采用彩色多普勒超声检查的SADG患者753例,并经手术病理证实,对比研究诊断结果,回顾性分析SADG的临床病理特点与超声图像特征的相关性.结果:本组SADG共753例,超声诊断敏感性98.26%,特异性84.42%,准确性89.77%.阳性预测值89.77%,阴性预测值89.61%.其中胆固醇性息肉与临床病理的阳性预测值达92.72%.在合并胆囊炎和胆囊结石两组中,SADG临床病理组织学差异有显著性意义(t=3.417,P<0.05).SADG≤10mm者占92.30%(695/753),其中良性SADG占99.14%(689/695);恶性SADG为0.86%(6/695).SADG>10mm者占7.70%(58/753),其中良性SADG占56.90%(33/58);恶性SADG为43.10%(25/58).良性与恶性息肉的直径差异有非常显著性意义(t=15.381,P<0.01).结论:超声诊断胆固醇性息肉与临床病理的阳性预测值达90%以上,具有较高的临床实用价值,是诊断SADG的首选方法.展开更多
基金Supported by The 2011 Ministry of Health Key Clinical Speciality Center ProjectChina
文摘This study explored the clinical value of endoscopic ligation for the treatment of upper gastrointestinal(GI)protuberant lesions in children.According to the appearance and size of lesions,we used different ligation techniques for the treatment of the lesions.Endoscopic ultrasonography was used for preliminary characterization of the lesions.One case diagnosed with PeutzJeghers syndrome was successfully treated by a detachable snare.Two cases with semi-pedunculated or broad-base lesions originating from the submucosal layer of the upper GI were treated with endoscopic variceal ligation;endoscopic examination showed that one case had complete healing 11 wk after ligation,while an ulcer scar was observed at the ligation site after 6 wk in the other case.All lesions were successfully ligated at the first attempt.No significant complications occurred either during or after the procedure.Selective endoscopic ligation of upper GI lesions is an effective and safe treatment for upper GI protuberant lesions in children.
基金Project (No. 491010-W10495) supported by the Scientific ResearchFoundation of Medicine and Health of Zhejiang Province, China
文摘Objective： The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography （CT） and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography （PUS） with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods： Patients with duodenal protruding lesions who were indicated for PUS were examined by PUS with 12-15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of PUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of PUS. Those patients without endoscopic resection or surgical excision were periodically followed up with PUS. Results： A total of 169 patients with duodenal protruding lesions were examined by PUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner＇s gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After PUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of PUS, with 93.33% diagnostic accuracy. The results of follow-up with PUS indicated that duodenal cyst, Brunner＇s gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1-3 years. No related complications occurred among all patients that received PUS examinations. Conclusion： PUS is an effective and reliable diagnostic method for duodenal protruding lesions.
文摘目的:探讨胆囊小隆起性病变(small apophysis disease of the gallbladder,SADG)的临床病理学特点与超声诊断中的相关性.方法:采用彩色多普勒超声检查的SADG患者753例,并经手术病理证实,对比研究诊断结果,回顾性分析SADG的临床病理特点与超声图像特征的相关性.结果:本组SADG共753例,超声诊断敏感性98.26%,特异性84.42%,准确性89.77%.阳性预测值89.77%,阴性预测值89.61%.其中胆固醇性息肉与临床病理的阳性预测值达92.72%.在合并胆囊炎和胆囊结石两组中,SADG临床病理组织学差异有显著性意义(t=3.417,P<0.05).SADG≤10mm者占92.30%(695/753),其中良性SADG占99.14%(689/695);恶性SADG为0.86%(6/695).SADG>10mm者占7.70%(58/753),其中良性SADG占56.90%(33/58);恶性SADG为43.10%(25/58).良性与恶性息肉的直径差异有非常显著性意义(t=15.381,P<0.01).结论:超声诊断胆固醇性息肉与临床病理的阳性预测值达90%以上,具有较高的临床实用价值,是诊断SADG的首选方法.
