空回肠间质瘤的临床、影像和病理学研究

目的　探讨空回肠间质瘤诊断和治疗经验 .方法　对我经术后病理和免疫组化证实 13例空回肠间质瘤病例进行回顾性分析 .结果　本组患者主要临床表现为消化道出血、腹痛、头晕、乏力、黑便 ,发病至确诊时间 2月～ 7年 .术前选择性血管造影发现小肠出血 2例、核素扫描发现小肠出血 1例 .剖腹探查确诊 7例 ,腹腔镜探查确诊 4例 ,因其他疾病腹腔镜探查确诊 1例 ,术前确诊仅 1例 .随访 2月～ 9年 ,除 1例患者死于其它疾患外 ,余 12例患者均健在 ,未发现空回肠间质瘤复发 .结论　空回肠间质瘤预后甚好 ,但本病缺乏特征性的临床表现及有效的诊断手段 ,易致长期延误诊治 ;对长期不明原因的消化道出血患者及早行剖腹探查或腹腔镜探查是避免空回肠间质瘤长期延误诊治、改善患者预后的关键

Diagnose and Treatment of Stromal Tumor of Jejunum and Ileum: Experience in 13 Patients

Objective To summarize the experience in the diagnosis and treatment of stromal tumor of jejunum and ileum. Methods Thirteen patients with stromal tumor of jejunum and ileum confirmed by pathology post operation were retrospectively reviewed in our unite from Oct. 1993 to Oct. 2003. Results The major clinic signs of stromal tumor of jejunum and ileum included: digestive duct hemorrhage, abdomen pain, dizziness hypodynamia and melena. The period of patients having clinical symptom before operation in this group was from 2 mouth to 7 years. Hemorrhage site of small intestine were determine by digital subtraction angiography and radionuclide imaging 2 cases and 1 case respectively. In this group, 7 cases were diagnosed by exploratory laparotomy for melena, 4 cases diagnosed by laparoscopic laparotomy for melena, one case diagnosed by exploratory laparotomy for hepatic cyst. Only one case was diagnosed by small intestine endoscopy before operation. Follow up from 2 mouth to 9 years, 12 patients survived today except one case died of other disease. No patients of stromal tumor of jejunum and ileum recurrence had been found in this group. Conclusions Stromal tumor of jejunum and ileum has better prognosis, but this disease is lacks of special clinical symptom, sign and effective examination methods, so it is difficult to diagnose early. Digital subtraction angiography and radionuclide imaging are helpful to diagnose this disease. Exploratory or caparoscopic laparotomy is first choice for these patients with suspicious stromal tumor of jejunum and ileum.