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目的探讨嗜酸粒细胞胃肠炎(eosinophilic gastroenteritis,EG)的误诊原因及防范措施。方法对我院收治的1例误诊为十二指肠乳头癌的弥漫性EG的临床资料进行回顾性分析,并复习相关文献。结果患者因右上腹痛伴间断发热1年,加重伴呕吐2周入院,对青霉素及多种食物过敏,先后在当地医院及我院进行胃十二指肠镜、B超、CT及MRI等检查,怀疑十二指肠肿瘤,但活组织病理检查未发现肿瘤证据。考虑十二指肠乳头癌可能性大,行剖腹探查术,术中冷冻病理检查也未发现肿瘤证据,应患者家属要求行胰十二指肠切除术,术后病理检查证实为弥漫性EG。予相应治疗,患者恢复顺利出院。结论 EG发病率低,临床表现不典型,影像学改变有时类似十二指肠乳头癌,临床医师应注意二者的鉴别诊断。
Objective To investigate the misdiagnosis and prevention of eosinophilic gastroenteritis (EG). Methods A retrospective analysis was performed on the clinical data of diffuse EG, which was misdiagnosed as duodenal papillary carcinoma in our hospital, and the related literatures were reviewed. Results The patients were admitted to the hospital due to right upper quadrant pain with intermittent fever for 1 year, aggravated with vomiting for 2 weeks and were allergic to penicillin and various foods. Gastroduodenoscopy, B-, CT and MRI were performed successively in local hospitals and our hospital. Duodenal tumors were suspected, but no tumor evidence was found by biopsy. Consider the possibility of duodenal papilla large, laparotomy, intraoperative frozen pathology also found no evidence of cancer, the patient’s family required pancreaticoduodenectomy postoperative pathology confirmed diffuse EG. To the appropriate treatment, the patient recovered successfully discharged. Conclusion The incidence of EG is low, the clinical manifestations are not typical, the imaging changes sometimes similar to duodenal papillary carcinoma, clinicians should pay attention to the differential diagnosis between the two.