原发性小肠肿瘤误诊分析

目的：探讨原发性小肠肿瘤的临床特点及误诊原因。方法：1990年以来诊治的39例原发性小肠肿瘤的临床资料及随访结果进行回顾性分析。结果：39例中20例被误诊，误诊时间1～15个月，误诊率51．3％。良性肿瘤6例，恶性肿瘤14例，肿瘤位于十二指肠3例，空肠9例．回肠8例。最常见的临床表现为腹痛、腹块、消化道出血、肠梗阻、黄疸等。20例均经手术治疗，其中15例获随访，死亡12例，存活8例。B超、CT诊断符合率较低，DSA检查有助于确定病变的部位及性质。结论：误诊的原因为对本病认识不足，临床表现不典型、早期诊断极为困难。改善病人预后的关键是加强对本病的重视和认识。

Analysis of Clinical Misdiagnosis on Primary Small Intestinal Tumor:a Report of 20 Cases

Objective: To explore the clinical characteristics and causes of misdiagnosed diagnosis of primary small intestinal tumors. Methods: A retrospective analysis was made on the clinical data and follow-up of 39 cases of primary small intestinal tumor treated from 1990.Results: Among them, 20 of 39 cases were misdiagnosed for 1 to 15 months.Preoperative misdiagnosis rate was 51.3%.In this group,6 cases were benign tumors while the other 14 cases were malignant Tumors located at duodenum, jejunum and ileum were found in 3 cases,29 cases and 8 cases respectively. The most common clinical presentations were abdominal pain, abdomen mass,gastrointestinal haemorrhage and jaundice,etc. All the 20 cases underwent operation,2 15 cases were followed up,of which 12 cases died. while the other 8 cases survived. The accurate diagnosis rate of B-ultrasound /CT scanning was lower, while Digital Subtract Angiography was helpful to make sure the portion and quality of the lesion. Conclusion:The reasons of misdiagnosis were following: Insufficient understanding about the disease, the clinical presentation of primary small intestinal tumor is untypical and early diagnosis for malignancy is quite difficult, so intensive study and recognization of this lesion should be emphasized to improve the prognosis of these patients.