興味ある所見を呈した巨大胃ポリープの1例

A Huge Mass of Gastric Polyps with Interesting Findings

　胃集団検診および胃内視鏡の発達によって，小さな胃ポリープも発見されるようになり，最近はその悪性化および外科的治療なども色々と検討されているが，筆者らは貧血症状を主訴とした患者の胃透視所見で十二指腸球部の陰影欠損をみとめた巨大胃ポリープの十二指腸脱出例を経験したので報告する．

　A shadow defect was found in the duodenal cap of a 74-year-old man complaining of anemia when he underwent x-ray examination of the upper digestive tract. By endoscopy the stalk of a gastric polyp was recognized in the pyloric antrum that had prolapsed into the duodenum. The resectecl stomach revealed on the posterior wall of the antrum a cauliflower-like, giant group of ten polyps, measuring from as large as 4.0×3.0×2.5 cm to the tip of a small finger. Histologic study of the tumors showed that they. were all adenomatous polyps. A gastric polyp that have prolapsed into the lumen of the duodenal cap must be differentiated from primary tumor of the duodenal bulb. Roentgenologically, a shadow defect in the bulb and the deformity as well as spasm of the gastric antrurn are findings of importance in the discrimination, while in endoscopy convergence of the mucosal folds on the pylorus is a distinctive feature equally important.