胃肠道气囊肿内镜下特点的临床分析_张媛媛

・临床论著・ 胃肠道气囊肿内镜下特点的临床分析

张媛媛李晶高莉吴芸刘玉兰

【摘要】 目的 通过分析胃肠道气囊肿内镜下表现的特点，提高临床医师的内镜诊断水平。

方法 回顾性分析北京大学人民医院消化内科2005年1月至2015年5月内镜中心80例诊断为气

囊肿患者的临床和内镜资料，包括25例上消化道（胃和十二指肠）气囊肿和55例下消化道（结肠

和直肠）气囊肿，对两组患者之间性别、年龄、是否多发以及内镜下特点进行统计学分析。结果 将

上消化道气囊肿和下消化道气囊肿两组进行比较，性别、年龄、是否多发、表面是否有糜烂两组差异

无统计学意义（P＞0.05），下消化道气囊肿的直径[（16.93±9.28）mm]显著大于上消化道气囊肿

[（9.72±5.36）mm，P=0.001]。上消化道气囊肿多见于十二指肠降部和球部，下消化道气囊肿多见

于升结肠和盲肠。气囊肿在内镜下表现为黏膜下透明囊样圆形或椭圆形隆起，超声内镜可以观察到

黏膜下气体影，腹部CT可见消化道壁内多发气体影。结论 下消化道气囊肿的直径显著大于上消

化道气囊肿；上消化道气囊肿多分布于十二指肠降部和十二指肠球部，下消化道气囊肿多分布于升

结肠和盲肠。

【关键词】内窥镜检查，胃肠道；腔内超声检查；气囊肿

Clinical analysis of the endoscopy features of pneumatosis cystoids in gastrointestinal tract Zhang

Yuanyuan, Li Jing, Gao Li, Wu Yun, Liu Yulan. Department of Gastroenterology, the People's Hospital of

Peking University, Beijing 100044, China

Corresponding author: Liu Yulan, Email: liuyulan@

【Abstract】 Objective To describe the clinical and endoscopy features of pneumatosis cystoids

in gastrointestinal tract. Methods We retrospectively reviewed the clinical and endoscopic findings in 80

patients who were diagnosed as pneumatosis cystoids in gastrointestinal tract in Peking University People's

Hospital between 2005 to 2015, including 25 cases in the upper GI tract and 55 cases in the lower GI tract.

We analyzed the gender, age and the endoscopic characteristics. Results Between the two groups of

upper GI tract and lower GI tract, the age, gender, the percentage of multiple lesion, the percentage of

erosion had no significant difference (P>0.05). The size of pneumatosis of lower GI [(16.93±9.28)mm] was

larger than that of upper GI [(9.72±5.36)mm] significantly (P=0.001). The upper GI pneumatosis cystoids

were often found in descending part and bulb of duodenum, while the lower GI pneumatosis cystoids in the

ascending colon and cecum. The endoscopy findings showed transparent submucosal lesions, while EUS

showing the gas in the lesions. The CT scan showed the gas accumulation within the bowel walls.

Conclusion The lower GI pneumatosis cystoids, which often found in ascending colon and cecum were

larger than the upper GI pneumatosis cystoids often found in duodenum.

【Key words】Endoscopy, gastrointestinal; Endosonography; Pneumatosis cystoids intestinalis

胃肠道气囊肿症（pneumatosis cystoids intestinalis）指胃肠道黏膜下、浆膜下或者两者均有多发的含气的囊肿，可累及从食管至直肠的全部或部分胃肠道[1]， 部分患者无明显症状，也可以有腹胀、腹泻、腹痛

DOI:10.3877/cma.j.issn.1674-0785.2016.23.001

基金项目：国家自然科学基金（81200626）

作者单位：100044 北京大学人民医院消化内科

通讯作者：刘玉兰，Email: liuyulan@ 及肠梗阻等表现[2]。随着内镜检查和影像学技术的普及，该疾病的发病率逐渐增多，国外报道的该病发病率为万分之三[3]，我国目前的相关临床资料较少，仅有少数病例报道，尤其是对该疾病的内镜下特点缺乏相应资料，为此本研究对消化道气囊肿的临床和内镜下特点进行回顾性总结，旨在提高临床医师对该疾病的诊断水平。