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目的探讨原发性小肠肿瘤的临床特点及诊断方法。方法回顾性分析 1 1 2例原发性小肠肿瘤的临床资料、病理特征及术前诊断方法。结果小肠肿瘤多位于十二指肠 ,占 62 5 %(70 / 1 1 2 ) ,良性肿瘤以平滑肌瘤为主 ,多位于回肠、空肠 ,恶性肿瘤以腺癌最常见 ,其次为恶性淋巴瘤 ,平滑肌肉瘤。首选的检查方法为X线钡餐 ,尤其是低张小肠灌肠造影 ,内镜检查可提高十二指肠肿瘤的诊断率 ,对诊断困难的消化道出血可行选择性肠系膜上动脉造影 ,CT对判断肿瘤的良恶性、术前分期及术后有无复发有独特的意义。结论十二指肠腺癌是最常见的原发性小肠肿瘤 ,其次为恶性淋巴瘤、平滑肌瘤及平滑肌肉瘤。低张小肠灌肠造影是诊断和定位最为有效的方法 ,CT、内镜及肠系膜上动脉造影有助于诊断。
Objective To explore the clinical features and diagnostic methods of primary small bowel tumors. Methods The clinical data, pathological features, and preoperative diagnostic methods of 119 cases of primary small bowel tumors were retrospectively analyzed. Results Tumors of the small intestine were mostly in the duodenum, accounting for 62.5% (70/112). Benign tumors were mainly leiomyomas, mostly located in the ileum and jejunum. Malignant tumors were most common with adenocarcinoma, followed by malignant lymphoma. , leiomyosarcoma. The preferred method of examination is X-ray barium meal, especially low-intestinal enema. Endoscopic examination can improve the diagnostic rate of duodenal tumors. Selective superior mesenteric artery angiography is feasible for the diagnosis of difficult gastrointestinal bleeding. The benign and malignant, preoperative staging and postoperative recurrence have unique significance. Conclusion Duodenal adenocarcinoma is the most common primary small bowel tumor, followed by malignant lymphoma, leiomyoma, and leiomyosarcoma. Low-intestinal enema is the most effective method for diagnosis and localization. CT, endoscopy, and superior mesenteric arteriography are helpful for diagnosis.