Ultrasound Journal 5: Hidden World Under the Mucosa - ??? ??? ?? Gastric Wall? Ectopic Pancreas ??
2022-11-15
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- ??? ??? ? gastric window? ?? ?? ??? ??? ?? gastric wall? ?? ?? ?? ??? ??? ??? ??? ??? ??? ? .
- Color Doppler? ectopic pancreas ??? ??? ?? ??? ? .
Case Description:
32? ? 1? ?? ??? epigastric discomfort ??? ?? ???. ??? ?? ?? ?? ??? , ??? (???)?? gastrointestinal malignancy ? ??? ???, ?? ? ??? ?.
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2018?, ??? ? ??? ??? ?? chronic gastritis, ??? gastric antrum?? lesser curvature? submucosal bulging mass? ??? ??? ?. (?? 1).
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2019?, ??? ??? ??? gastric antrum?? lesser curvature? submucosal bulging mass? ?? submucosal ectopic pancreas? ???. (?? 2)
Gastric window? ?? ?? ??? ??:
??? ???(instant gastrointestinal ultrasound aid) 500mL? ?? ?? ? ??? ??? ?. Gastric wall? ??? ?? ??? ?? ??, Gastric antrum? lesser curvature? submucosal layer??? ? 1.36cm×0.87cm ??? ?? ??? hypoechoic mass? ???. ??mass? ? ? , ?? ???.
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???, mass? ??? ?? ??? ?, mass ? echogenicity ? ???.(?? 3).
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CDFI(Color Doppler Flow Imaging)? ?? ?? ??? ??? mass? ??? ??? ? ??? ???. (?? 4) ??? ?(stomach)? submucosal ??? ?, ectopic pancreas? ???.
Procedure:
??? ?? ??? ??? ?? contraindication ?? ??? , endoscopic submucosal dissection(ESD)? ??.
Postoperative diagnosis:
Mucosa?? ??? ectopic pancreatic tissue? ??? gastric mucosa? ??? ??? ??..
Discussion:
Aberrant pancreas ?? accessory pancreas? ??? ectopic pancreas? ??? ?? ?. Ectopic pancreas ??? 90%? gastrointestinal tract? ?, jejunum(??), ileum(??), Meckel diverticulum(??? ???), gallbladder(??), bile duct(??) ? ?? ? ?. Ectopic pancreas ??? ? , ?? ?? ?, ??? ?? ?. ??? ? ??? ?? , ?? gastric cavity? . ?? ? ??? 2.0cm? ? ??? ??? .
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?Ectopic panaceas? ?? ?? ??? acini? pancreatic duct? ??? ?? ?. ??? isoechoic?? ??? hypoechoic???. ??? ??? medium ?? hypoechoic? substantial mass? , ??? ? ? echogenicity? ??? ???, mass ??? gastric wall? well-layered? ??? ???. Submucosa??? ectopic pancreas? ?? digestive tract? central-duct ?? ??? umbilical depression? ?.
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??? ?? ?? ? ??? ?? mass ??? mucosal layer, mucosal muscle layer, muscle layer ?? serosal layer? ? ??? ?? ??? ??. Submucosal? ?? hypoechoic, ??? ??? central depression? ???, gastric peristaltic wave? ?? ??? mass??? ??? mucosal fold? ??? ? ?? sound attenuation? ?. ???, gastric wall? ? ?? ?? peristaltic wave? mass? ??? ??? ??? . Ectopic pancreatic tissue ?? ?? ??? ??? ??? ?? ??, Color Dopler ultrasound (CDUS)? mass? ? ?? ?? ??? ?? gastric ectopic pancreas? ?? ??? ?? ??? ?? ? ???, ??? ??? ? ??? ???.
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? ??? ?? submucosal ??? gastric leiomyoma(?), mesenchymoma(???)? ? ???. ?? ?? ??? ? gastric window? ?? ?? ?? gastric window? ?? layer? ??? ??? ??? ??? ?? ?? ??? ?? differential diagnosis? ??? ? .