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 explore misdiagnosis causes of eosinophilic gastroenteritis ( EG) and preventive measures. Methods Clinical data of one patient with EG misdiagnosed as duodenal papillary carcinoma was retrospectively analyzed and relevant literature was reviewed. Results The patient with right upper abdominal pain and intermittent fever for 1 year was admitted for the 2 weeks of aggravation and vomiting. The patient was allergic to penicillin and many foods, but was suspected as having duodenal tumor according the results of gastroduodenoscopy, abdominal B ultrasound, CT and MRI. No evidence was found in biopsy. Considered as duodenal papillary carcinoma, the patient underwent exploratory laparotomy, and no evi-dence of tumor was found in intraoperative pathological examination. Then the patient's family members asked for pancreati-coduodenectomy. Diffuse EG was confirmed by the postoperative pathological diagnosis. After corresponding treatment, the patient was discharged after recovery. Conclusion The incidence of EG is low. The atypical clinical manifestations and ima-ging changes sometimes are similar to gastric cancer or duodenal papillary carcinoma, so more attention should be paid to the differential diagnosis.
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