Résumé
Gastritis cystica polyposa is an uncommon lesion that usually occurs at the gastroenterostomy site, but it may also develop in the non-operated stomach. This malady is characterized by polypoid mucosal changes with hyperplasia and cystic dilatation of glands that infiltrate into the submucosal layer. We report here on a case of gastritis cystica polyposa that presented as a mass impacted in the duodenum in a 63-year-old male, and this patient had been admitted for evaluation of progressive epigastric fullness and dyspepsia. Esophagogastroduodenoscopy revealed that the partial duodenal obstruction was caused by impaction of a huge polypoid mass with a stalk that originated from the lower body of the stomach. We fished out the impacted mass with a forceps catheter while holding the neck with a snare catheter. Thereafter, an endoloop was applied to the stalk of mass, and this was followed by polypectomy using a snare catheter.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Cathéters , Dilatation , Occlusion duodénale , Duodénum , Dyspepsie , Endoscopie digestive , Gastrite , Gastroentérostomie , Hyperplasie , Cou , Protéines SNARE , Estomac , Instruments chirurgicauxRésumé
Gastritis cystica polyposa (GCP) is a rare lesion characterized by hyperplastic and cystic dilatation of the gastric mucous glands infiltrating into the underlying submucosa. A cumulative experience suggests that GCP represents a manifestation of a spectrum of reactive inflammatory responses to mucosal injury. The case reported herein is a GCP developed as multiple polypoid lesions with a circular arrangement in the gastric mucosae along the gastrojejunostomy site.
Sujets)
Dilatation , Dérivation gastrique , Muqueuse gastrique , GastriteRésumé
Gastritis cystica polyposa (GCP) which is characterized by polypoid hyperplasia of the gastric mucosa, is known as an uncommon lesion that usually occurs at the gastroenterostomy site, although rarely it can be found in an unoperated stomach. Recently, GCP has been proposed to be a possible precancerous lesion itself. We present a rare case of GCP which presented as a large soft polypoid mass with a stalk in a previously unoperated stomach. A 44-year-old woman was admitted due to further study of large gastric mass. Previously, she had not undergone gastric surgery. Physical examination disclosed nothing abnormal. and laboratory test showed iron deficiency anemia. Endoscopy showed a large soft polypoid mass in gastric fundus and endoscopic ultrasonography showed a homogenous hypoechoic, and multilocular cystic mass with a stalk. We removed it via endoscopic polypectomy and histologic examination of this polypoid specimen showed the features consistent with the diagnosis of GCP.
Sujets)
Adulte , Femelle , Humains , Anémie par carence en fer , Diagnostic , Endoscopie , Endosonographie , Fundus gastrique , Muqueuse gastrique , Gastrite , Gastroentérostomie , Hyperplasie , Examen physique , EstomacRésumé
Gastritis cystica polyposa was diagnosed in three patients with ages of 49, 56 and 66 years. All patients had been operated on for gastric cancer 1 to 5 years earlier, with Billroth II gastroenteric anastomose being made at that time. The lesions were diagnosed by regular follow-up endoscopic examination without any presenting symptoms. Macroscopically, all lesions were located on the gastric side of the anastomosis, with polypoid growth of 1.5x1.0, 2.0x1.5, and 0.5x0.5 cm in size respectively. The surfaces of the lesions were coarsely nodular and brittle, and one of them protruded into the anastomosis lumen. Histologic examination revealed polypoid mucosal changes associated with functionally active, hyperplastic and cystic dilatation of the glands which had infiltrated to into the underlying submucosa. An endoscopic polypectomy was performed in two patients, and all has gone well, without evidence of a recurrent tumor 6 & 18 months after polypectomy. The other patients refused a polypectomy. Gastritis cystica polyposa should be differentiated from a stump carcinoma to avoid a further unnecessary surgical intervention. Awareness of the entity will lead to better diagnosis of gastritis cystica polyposa.
Sujets)
Humains , Diagnostic , Dilatation , Études de suivi , Gastrite , Gastroentérostomie , Tumeurs de l'estomacRésumé
Gastritis cystica polyposa(GCP) is a polypoid cystic lesion showing all the histological features of the hyperplastic polyps and the cysts penetrating through the mucularis mucosae. Most reported GCP lesions were developed at gastraenterostomy stomas. It is rare that GCP develops without history of previous gastroenterostomy. In 1990, however, Kim et al reported a GCP presenting as a submucosal tume-like lesion in a 69-year-old man. Recently, we had experienced two consecutive cases of GCP diagnosed by endoscopic polypectomy. The first case was 49-year-old housewife without history of previous gastric surgery. Esophagogastroduodenoscopy(EGD) showed a 2.0x1.5x1.5cm sized lobulated polypoid lesion with a broad stalk on the anterior wall of the distal antrum. The second case was 45-year-old woman without history of previous gastric surgery. EGD revealed a 1.0 x 1.0 x l.0 cm sized polypoid lesion with a pedicle on the greater curvature aspect of the upper body and two duodenal ulcers with pseudodiverticulum formation. These lesions were endoscopically polypectomized and diagnosed as GCP by the histologic examination.