临床荟萃 ›› 2024, Vol. 39 ›› Issue (9): 828-832.doi: 10.3969/j.issn.1004-583X.2024.09.012

• 论著 • 上一篇    下一篇

直肠帽状息肉病1例并文献复习

顾丹丹1, 周晓娴2, 王婧娴1, 吴春晓2()   

  1. 1.石家庄市中医院 肛肠科 河北 石家庄 050011
    2.河北省中医院 肛肠科 河北 石家庄 050011
  • 收稿日期:2023-09-25 出版日期:2024-09-20 发布日期:2024-09-24
  • 通讯作者: 吴春晓 E-mail:cxeye@126.com
  • 基金资助:
    河北省中医药管理局科研计划项目——穴位埋线治疗结肠黑变病的临床研究及机理初探(2022068)

Rectal cap polyposis: A case report and literature review

Gu Dandan1, Zhou Xiaoxian2, Wang Jingxian1, Wu Chunxiao2()   

  1. 1. Department of Colorectal Medicine,Shijiazhuang Traditional Chinese Medicine Hospital, Shijiazhuang 050011,China
    2. Department of Colorectal Medicine,Hebei Province Hospital of TCM, Shijiazhuang 050011,China
  • Received:2023-09-25 Online:2024-09-20 Published:2024-09-24
  • Contact: Wu Chunxiao E-mail:cxeye@126.com

摘要:

目的 探讨直肠帽状息肉病的临床特征,提高对其认识及诊治技术。方法 回顾性分析河北省中医院收治的1例直肠帽状息肉病患者的病例资料,并结合已发表的国内外相关文献进行复习。结果 患者青年男性,因间断黏液血便就诊,专科查体见直肠下段齿线附近多个半球状肿物突向肠腔,表面糜烂坏死,上覆大量黄白色脓性分泌物,多次取病理活检提示为炎性改变,经保守抗炎对症治疗3个月,患者黏液血便症状改善,但镜下病损无变化,后经手术切除后痊愈,结合术后病理结果,确诊为“直肠帽状息肉病”,随访1年未见复发。结论 直肠帽状息肉病是一种临床罕见的非肿瘤性疾病,为炎性息肉的一种特殊类型,临床诊断主要依据镜下特征性“帽状”改变及病理检查结果,保守治疗或可达到缓解症状的目的,但对于保守效果不佳者,根除病灶仍首选手术治疗。

关键词: 帽状息肉病, 直肠, 炎性息肉, 幽门螺杆菌

Abstract:

Objective To explore the clinical characteristics of rectal cap polyposis, thus improving its understanding for clinical diagnosis and treatment. Methods Clinical data of a case of rectal cap polyposis treated in the Hebei Province Hospital of TCM were retrospectively analyzed, and relevant literatures published both domestically and internationally were reviewed. Results A young male patient presented for intermittent mucous bloody stool. Specialized physical examination revealed multiple hemispherical masses protruding towards the intestinal cavity near the lower segment of the dentate line, with erosion and necrosis observed on the surface, and covered with massive yellow white purulent secretions. Multiple pathological biopsies suggested inflammatory changes. After conservative anti-inflammatory and symptomatic treatment for 3 months, although the symptom of mucous bloody stool improved, microscopic lesions remained unchangeable. Surgical resection yielded a cure. Combined with postoperative pathological results, the patient was diagnosed as rectal cap polyposis. No recurrence was observed during a 1-year follow-up. Conclusion Rectal cap polyposis is a rare non-tumor disease and a special type of inflammatory polyp. A clinical diagnosis is usually made based on the characteristic “cap-like” changes under the microscope and pathological examination results. Conservative treatment may achieve the goal of relieving symptoms, but surgery for eradicating the lesion is preferred to those with a poor outcome of conservative treatment.

Key words: cap polyposis, rectum, inflammatory polyposis, helicobacter pylori

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