Duodenal lesions in familial polyposis of the colon.
Duodenal lesions in familial polyposis of the colon.
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家族性结肠息肉病的十二指肠病变。
DOI：
10.1016/s0016-5085(19)31863-3
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发表时间：
1977
期刊：
影响因子：
29.4
通讯作者：
T. Omae
中科院分区：
文献类型：
--
作者：
T. Yao;M. Iida;K. Ohsato;Hidenobu Watanabe;T. Omae
对14例家族性结肠息肉病患者行低张十二指肠造影、十二指肠纤维镜检查和十二指肠镜活检。在14名患者中，有13名患者的X线或内窥镜检查显示十二指肠内有大小不一的腺瘤。在其余1例患者中，意外地从乳头区采集的活检标本显示为腺瘤，尽管十二指肠造影和内窥镜检查均未发现任何异常。腺瘤多为多发，体积较小(直径小于5 mm)，位于十二指肠第二段，少数为单发大腺瘤。文献中仅有29例家族性结直肠息肉病患者伴有十二指肠癌或腺瘤。然而，目前的研究强烈表明，十二指肠病变的发生率可能比先前认为的更高。在许多病例中，这些病变肯定被忽视了，因为传统的十二指肠造影技术不足以发现如此小的腺瘤。家族性结肠息肉病胃或十二指肠腺瘤性病变的高发和各种器官良恶性肿瘤的并发症，提示该病是一种全身性或全身性疾病，而不是结肠本身的疾病，尽管病因尚不清楚。因此，“家族性结肠腺瘤病综合征”似乎比“家族性结肠息肉病”更贴切。
Hypotonic duodenography, duodenofiberscopy, and endoscopic biopsy of the duodenum were performed in 14 patients with familial polyposis of the colon. In 13 of the 14 patients, a roentgenographic or endoscopic study revealed adenomas of various size in the duodenum. In the remaining 1 patient, a biopsy specimen which was taken accidentally from the papillary region showed adenoma, although neither duodenography nor endoscopy revealed any abnormality. Adenomas in most cases were multiple and relatively small in size (less than 5 mm in diameter), and sited in the second portion of the duodenum, whereas a solitary and large adenoma was found in rare cases. There have been reported in the literature only 29 patients with familial polyposis of the colon who had concomitant cancers or adenomas of the duodenum. However, the present study strongly suggests that the incidence of duodenal lesions might be higher than that previously considered. In many cases, these lesions must have been overlooked, because the conventional technique of duodenography was not sufficient to detect such small adenomas. A high incidence of adenomatous lesions of the stomach or the duodenum and complications of benign or malignant tumors of various organs in familial polyposis of the colon may suggest that this disease is a systemic or generalized disorder rather than the disease of the colon per se, despite the etiology being still uncertain. Therefore, the term “familial adenomatosis coli syndrome” seems to be more appropriate than “familial polyposis of the colon.”