使用内镜肌切除术和内镜超声波扫描成功诊断了直肠植入囊
Eisuke Kameoka1, Takuto Hikichi2, Minami Hashimoto1,3
1Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Clinical journal of gastroenterology
|May 18, 2024
概括
一名直肠癌患者在手术后出现了下皮质病变. 这种质量被诊断为外部植入囊,而不是粘膜下瘤,需要超越标准内镜剖析进行更深入的调查.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 一个患有直肠癌病史的患者接受了腹腔镜辅助的前部低切除和双接技术,并呈现出一个解静脉质块.
- 该质量最初在结肠镜检查中被视觉化为亚皮质病变,并通过内镜超声波 (EUS) 假定位于亚粘膜.
研究的目的:
- 报告一个罕见的异体植入囊的病例,呈现为异体质.
- 突出这些病变的诊断挑战和内镜治疗.
主要方法:
- 计算机断层扫描 (CT) 和结肠镜用于初步评估.
- 用内镜超声波 (EUS) 引导的细针吸收 (FNA).
- 内镜下层剖析 (ESD) 和随后的EUS用于病变定位.
- 在手术内进行内镜肌肉层切割和活检.
主要成果:
- 一位81岁的老妇人呈现了5年后的直肠癌前下切除后的直肠质量.
- 最初的EUS-FNA是无诊断的;ESD没有显示下膜病变.
- 此外,EUS还发现了一个外质量.
- 透视肌肉层切口释放了粘液,揭示了与植入囊一致的闭合光线.
结论:
- 额外内植入囊可以在直肠手术后呈现为静脉动质.
- 一个逐步的内镜方法,包括EUS和肌肉层剖析,可以帮助诊断.
- 这一案例凸显了在手术后的静脉质群体中考虑外病理的重要性.
关键词:
内镜肌肉切除术 (endoscopic myotomy) 是一种内镜肌肉切除术.内镜下粘膜切割 进行内镜下粘膜切割.植入囊 植入囊是一种植入囊.周边静脉囊 周边静脉囊 周边静脉囊 周边静脉囊下皮质病变的发生.更多相关视频
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