{"title":"作为肠套叠患者导引点的空肠异位胰腺组织息肉:罕见病例报告和文献综述。","authors":"Worku Mekonnen Sefefe, Destaw Biadgie Tesfaw, Andualem Dagne Tebikew, Assefa Sisay Ayenew, Bereket Amare Dencha, Temesgen Agegnehu Abebe","doi":"10.2147/CEG.S425986","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Ectopic pancreas (EP), characterized by pancreatic tissue outside its usual location, poses diagnostic challenges due to its asymptomatic nature in most cases. Gastric lesions are often symptomatic, causing epigastric pain or gastric outlet obstruction. Rarely, jejunal lesions can lead to intestinal obstruction or intussusception. The elusive preoperative diagnosis lacks specific biochemical markers, relying on intraoperative biopsy and histopathology as gold standards.</p><p><strong>Case presentation: </strong>We present a unique case of a 37-year-old female with 12-hour crampy abdominal pain, bilious vomiting, blood-mixed diarrhea, abdominal distension, and obstructive symptoms. Imaging revealed jejunojejunal intussusception with a jejunal mass as the lead point. Intraoperatively, also identified jejunal mass as lead point. Resection of mass and end-to-end jejunojejunal anastomosis were performed, resulting in a successful outcome. Histopathological examination identified a type I ectopic pancreas within the muscularis propria. Twelve months postoperatively, the patient exhibited no stricture or recurrence.</p><p><strong>Conclusion: </strong>Ectopic pancreas, with varied symptoms, poses diagnostic hurdles. Despite the diagnostic challenges, surgical excision remains the optimal treatment for symptomatic cases. This report contributes to the limited literature on ectopic pancreas, emphasizing the importance of considering this entity in the differential diagnosis of gastrointestinal pathology.</p>","PeriodicalId":10208,"journal":{"name":"Clinical and Experimental Gastroenterology","volume":"17 ","pages":"135-139"},"PeriodicalIF":2.5000,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067941/pdf/","citationCount":"0","resultStr":"{\"title\":\"Jejunal Ectopic Pancreatic Tissue Rest as Lead Point in Patients with Intussusception: A Rare Case Report and Review of Literature.\",\"authors\":\"Worku Mekonnen Sefefe, Destaw Biadgie Tesfaw, Andualem Dagne Tebikew, Assefa Sisay Ayenew, Bereket Amare Dencha, Temesgen Agegnehu Abebe\",\"doi\":\"10.2147/CEG.S425986\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Ectopic pancreas (EP), characterized by pancreatic tissue outside its usual location, poses diagnostic challenges due to its asymptomatic nature in most cases. Gastric lesions are often symptomatic, causing epigastric pain or gastric outlet obstruction. Rarely, jejunal lesions can lead to intestinal obstruction or intussusception. The elusive preoperative diagnosis lacks specific biochemical markers, relying on intraoperative biopsy and histopathology as gold standards.</p><p><strong>Case presentation: </strong>We present a unique case of a 37-year-old female with 12-hour crampy abdominal pain, bilious vomiting, blood-mixed diarrhea, abdominal distension, and obstructive symptoms. Imaging revealed jejunojejunal intussusception with a jejunal mass as the lead point. Intraoperatively, also identified jejunal mass as lead point. Resection of mass and end-to-end jejunojejunal anastomosis were performed, resulting in a successful outcome. Histopathological examination identified a type I ectopic pancreas within the muscularis propria. Twelve months postoperatively, the patient exhibited no stricture or recurrence.</p><p><strong>Conclusion: </strong>Ectopic pancreas, with varied symptoms, poses diagnostic hurdles. Despite the diagnostic challenges, surgical excision remains the optimal treatment for symptomatic cases. This report contributes to the limited literature on ectopic pancreas, emphasizing the importance of considering this entity in the differential diagnosis of gastrointestinal pathology.</p>\",\"PeriodicalId\":10208,\"journal\":{\"name\":\"Clinical and Experimental Gastroenterology\",\"volume\":\"17 \",\"pages\":\"135-139\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-04-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067941/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2147/CEG.S425986\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CEG.S425986","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:异位胰腺(EP)的特点是胰腺组织超出其正常位置,由于大多数病例无症状,因此给诊断带来了挑战。胃部病变通常无症状,会引起上腹痛或胃出口梗阻。空肠病变可导致肠梗阻或肠套叠,这种情况较为罕见。难以捉摸的术前诊断缺乏特异性生化指标,只能依靠术中活检和组织病理学作为金标准:我们介绍了一例独特的病例:37 岁女性,腹痛 12 小时,伴有胆汁性呕吐、血性混合性腹泻、腹胀和梗阻症状。影像学检查发现空肠空肠肠套叠,空肠肿块为先导点。术中也发现空肠肿块为前导点。手术切除了肿块并进行了空肠端端吻合术,最终取得了成功。组织病理学检查发现固有肌内有一个 I 型异位胰腺。术后 12 个月,患者未出现狭窄或复发:结论:异位胰腺症状多样,给诊断带来了困难。结论:异位胰腺的症状多种多样,给诊断带来了困难。尽管诊断困难重重,但手术切除仍是无症状病例的最佳治疗方法。本报告为有关异位胰腺的有限文献做出了贡献,强调了在胃肠道病理鉴别诊断中考虑这一实体的重要性。
Jejunal Ectopic Pancreatic Tissue Rest as Lead Point in Patients with Intussusception: A Rare Case Report and Review of Literature.
Background: Ectopic pancreas (EP), characterized by pancreatic tissue outside its usual location, poses diagnostic challenges due to its asymptomatic nature in most cases. Gastric lesions are often symptomatic, causing epigastric pain or gastric outlet obstruction. Rarely, jejunal lesions can lead to intestinal obstruction or intussusception. The elusive preoperative diagnosis lacks specific biochemical markers, relying on intraoperative biopsy and histopathology as gold standards.
Case presentation: We present a unique case of a 37-year-old female with 12-hour crampy abdominal pain, bilious vomiting, blood-mixed diarrhea, abdominal distension, and obstructive symptoms. Imaging revealed jejunojejunal intussusception with a jejunal mass as the lead point. Intraoperatively, also identified jejunal mass as lead point. Resection of mass and end-to-end jejunojejunal anastomosis were performed, resulting in a successful outcome. Histopathological examination identified a type I ectopic pancreas within the muscularis propria. Twelve months postoperatively, the patient exhibited no stricture or recurrence.
Conclusion: Ectopic pancreas, with varied symptoms, poses diagnostic hurdles. Despite the diagnostic challenges, surgical excision remains the optimal treatment for symptomatic cases. This report contributes to the limited literature on ectopic pancreas, emphasizing the importance of considering this entity in the differential diagnosis of gastrointestinal pathology.