gastric leiomyoma
Introduction
Introduction to gastric leiomyomas Leiomyomaofstomach is a benign tumor originating from smooth muscle tissue. It is the most common interstitial benign stomach tumor. Because of the absence of any clinical symptoms of leiomyoma with diameter <2cm, its incidence is actually higher. It has been reported that the autopsy rate of over 50 years old is as high as 50%. The clinical symptoms of this disease are not specific, the diagnosis rate is 21.1% to 42.9%, and the cancer rate is 2.1%. The early surgical treatment has a good prognosis, so it is worthy of clinical attention, and strive for early detection and achieve the purpose of early diagnosis and treatment. basic knowledge The proportion of sickness: 0.2% - 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: anemia, iron deficiency anemia, pyloric obstruction
Cause
Cause of gastric leiomyomas
Cause (35%):
Gastric leiomyoma is derived from smooth muscle tissue (multiple from the gastric wall ring muscle or longitudinal muscle), a small number of benign tumors from the mucosal muscle layer, which occur in the fundus, corpus, small curved side more common on the curved side. The rear wall is more than the front wall.
Prevention
Gastric leiomyoma prevention
A reasonable diet can take more high-fiber and fresh vegetables and fruits, balanced nutrition, including essential nutrients such as protein, sugar, fat, vitamins, trace elements and dietary fiber, with a combination of vegetarian and vegetarian foods. The complementary role of nutrients in food is also helpful in preventing this disease.
Complication
Gastric leiomyoma complications Complications anemia, iron deficiency anemia, pyloric obstruction
1. Anemia: Long-term chronic small amount of bleeding can cause iron deficiency anemia.
2. Pyloric obstruction: Large tumors located near the sacral sac can cause difficulty in swallowing. The giant leiomyomas located in the pylorus can cause pyloric obstruction.
Symptom
Symptoms of gastric leiomyomas Common symptoms Upper gastrointestinal bleeding, stomach tumbling or stirring, upper abdominal pain, pain, repeated vomiting, abdominal mass, digestive tract, peristalsis, uncoordinated abdominal pain, black stool shock
The clinical manifestations of leiomyomas are often related to the location, size, growth pattern, and type of complications of the tumor. Hemorrhage is the most common symptom, which can cause hematemesis or melena. Other symptoms include upper abdominal pain, fullness discomfort, etc. Upper abdominal mass may be found, moderate hardness, smooth performance, activity, no tenderness, slow progress, early or uncomplicated, often asymptomatic, accidentally found only during gastroscopy or stomach surgery or autopsy, the main symptoms and signs are summarized as follows.
1. Gastrointestinal hemorrhage: It is a prominent clinical manifestation of gastric leiomyoma. It has been reported in the literature that its incidence rate is 58%, often with intermittent small amount of bleeding, duration varies, occasional hemorrhage leads to shock, the occurrence of bleeding It is related to the compression of the mass or the formation of ischemic necrosis and surface ulceration due to insufficient blood supply to the tumor.
2. Abdominal pain due to tumor traction, compression of adjacent tissues or due to uncoordinated gastrointestinal motility, dysfunction, etc., often showing pain or pain, the location is not exact, more before the gastrointestinal bleeding or before the abdominal mass is found.
3. Abdominal mass: The contact of the abdominal mass is related to the size of the tumor and its growth site and growth mode. The diameter is >5cm, and the growth of the cavity is easy to reach.
Examine
Examination of gastric leiomyoma
1. Blood routine examination: There may be a decrease in red blood cells and hemoglobin, suggesting that anemia exists.
2. Fecal occult blood test: The digestive tract often presents intermittent small amount of bleeding, which is characterized by fecal occult blood test positive or black stool.
3. Histopathological examination: the tumor boundary is clear, there is no capsule, and the differentiated shuttle cells are staggered into bundles, and there are fibrous connective tissues and fibroblasts with different contents.
Diagnosis
Diagnosis and differential diagnosis of gastric leiomyoma
Diagnostic criteria
For the diagnosis of gastric leiomyoma, in addition to the clinical appearance of upper gastrointestinal bleeding, abdominal pain, abdominal mass, suspected and this disease, mainly rely on X-ray and gastroscopy, X-ray examination can be seen isolated, round or oval The filling defect, the mucosa around the tumor is normal, and there is a shadow in the filling defect area, suggesting that the leiomyomas have ulcers. When the tumor protrudes out of the stomach, the gastric wall deformity may appear, or the external pressure trace-like defect may be seen. The gastroscopy may be hemispherical or spherical. Uplift, mucous membrane tension is smooth, color is normal, there may be ischemic necrotic ulcer on the top, preoperative diagnosis is more difficult, often need to be confirmed.
Differential diagnosis
Mainly should be differentiated from gastric polyps, gastric peptic ulcer, etc., should be based on tumor size, growth characteristics, ulcer morphology, with or without metastasis and invasive growth, cystic changes, postoperative recurrence and pathological examination, especially Pathological examination is important. It is generally considered that the age of onset is >50 years old, the lesions are multiple, the diameter of the tumor is >5cm, the growth is faster, and the nodular shape, cystic and large irregular ulcers support leiomyosarcoma, should be timely Pathological examination to be clear.
