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[目的]总结十二指肠球部恶性肿瘤的临床特征,分析误诊原因,以降低其误诊率。[方法]回顾性总结本院2007-01-01—2013-12-31期间被误诊的十二指肠球部恶性肿瘤14例的临床资料。[结果]首发症状:腹痛6例,黑便3例,反酸3例,腹胀2例。病理类型:腺癌8例,黏液细胞癌3例,类癌2例,鳞状细胞癌1例。肿瘤部位:十二指肠球部前壁7例,小弯侧3例,后壁2例,弥漫型2例。内镜分型:溃疡型7例,隆起型5例,平坦糜烂型2例。误诊分布:十二指肠球部良性溃疡8例,息肉3例,十二指肠球炎2例,腺癌1例。[结论]十二指肠球部恶性肿瘤易误诊为十二指肠球部良性溃疡及息肉;提高对十二指肠球部恶性肿瘤的全面认识,重视上消化道内镜检查及组织学检查,可降低十二指肠球部恶性肿瘤的误诊率。
[Objective] To summarize the clinical features of duodenal malignancies and analyze the causes of misdiagnosis so as to reduce the misdiagnosis rate. [Methods] The clinical data of 14 cases of duodenal malignant tumor misdiagnosed in our hospital from January 2007 to January 13,2013 were retrospectively reviewed. [Results] First symptom: abdominal pain in 6 cases, melena in 3 cases, acid reflux in 3 cases, abdominal distension in 2 cases. Pathological types: adenocarcinoma in 8 cases, mucinous cell carcinoma in 3 cases, carcinoid in 2 cases, squamous cell carcinoma in 1 case. Tumor site: Duodenal anterior wall in 7 cases, 3 cases in the lesser curvature, posterior wall in 2 cases, diffuse in 2 cases. Endoscopic typing: ulcer in 7 cases, uplift in 5 cases, 2 cases of flat erosive. Misdiagnosis distribution: duodenal ulcer in 8 cases, polyp in 3 cases, 2 cases of duodenal inflammation, adenocarcinoma in 1 case. [Conclusion] Duodenal malignant tumors are easily misdiagnosed as benign duodenal ulcer and polyps; to improve the overall understanding of duodenal malignant tumors, emphasis on upper gastrointestinal endoscopy and histological examination , Can reduce the misdiagnosis rate of duodenal malignancy.