Gastric polyps

Brief introduction of stomach polyps Gastric polyps refer to papillary meat that grows on the surface of the gastric mucosa. There are no obvious symptoms in the early stage. It is usually found accidentally during gastrointestinal barium meal, gastroscopy or surgery for other reasons. The name polyp does not indicate its etiology and histological structure, but only the bulge observed by the naked eye. basic knowledge Sickness ratio: 0.5% Susceptible people: no specific population Mode of infection: non-infectious Complications: upper gastrointestinal bleeding pyloric obstruction

Gastric polyp cause

(1) Causes of the disease

At present, the cause of the disease is unknown. Gastric polyps refer to the uplift lesions that originate from the gastric mucosal epithelial cells protruding into the stomach.

(two) pathogenesis

Gastric polyps usually occur in the antrum of the stomach, and a few can also be found in the upper part of the stomach, the cardia and the fundus. The pathology is mainly divided into hyperplastic polyps and adenomatous polyps.

1. Proliferative polyps This type of polyp accounts for about 75% to 90% of gastric polyps. It is a polypoid formed by inflammatory mucosal hyperplasia. It is not a real tumor. The polyps are small. Generally, the diameter is less than 1.5cm. It is round or olive. Shaped, pedunculated or pedunculated, smooth surface, may be accompanied by erosion, histologically visible hyperplastic epithelium and hyperplastic lamina propria, epithelial differentiation, mitotic figures are rare, lamina propria see inflammatory cell infiltration, Some polyps are accompanied by intestinal metaplasia, and a few proliferative polyps can develop dysplasia or adenoma metastasis, but the cancer rate is generally less than 1% to 2%.

2. Adenomatous polyps are benign gastric tumors derived from gastric mucosal epithelium, accounting for about 10% to 25% of gastric polyps. Generally, they are large in size, spherical or hemispherical, most without pedicle, smooth surface, and few are flat. , strip or lobulated, histologically mainly formed by surface epithelium, epithelial and glandular hyperplasia, epithelial differentiation is immature, mitotic figures are more common, can be divided into tubular, villous and mixed adenoma, often accompanied There are obvious intestinal metaplasia and dysplasia, polyp interstitial is loose connective tissue, a small amount of lymphocytic infiltration, no obvious hyperplasia of mucosal muscle layer, no dispersion of muscle fibers, this type of polyp cancer rate is high, up to 30% to 58.3%, In particular, the diameter of the tumor is greater than 2cm, the villous adenoma, and the dysplasia III degree have a higher malignant rate.

Gastric polyp prevention

In order to prevent gastric polyps from becoming cancerous, we should insist on a gastroscopy every year to remove the polyps. In addition, we must strengthen self-care, keep eating and drinking, and try not to burden the stomach. As long as everyone is vigilant, they will Gastric cancer is rejected.

Gastric polyp complications Complications upper gastrointestinal bleeding pyloric obstruction

Patients with smashed or ulcers may have upper gastrointestinal bleeding, mostly manifested as fecal occult blood test positive or black stool, vomiting blood is rare, pedicled polyps located in the pylorus, can be detached into the pyloric or duodenum, and pyloric obstruction Performance, polyps can be swallowed when growing near the Tuen Mun.

Symptoms of gastric polyps Common symptoms Abdominal pain, bloating, loss of appetite, diarrhea, nausea, upper abdominal discomfort, black stomach, heartburn, upper abdominal pain

The disease is asymptomatic in the early stage or without complications. When symptoms appear, it often shows upper abdominal pain, abdominal distension, discomfort, a small number of nausea, vomiting, complication or ulceration may have upper gastrointestinal bleeding, and more manifested as fecal occult blood test. Positive or melena, vomiting blood is rare, pedicled polyps located in the pylorus, can be detached into the pyloric or duodenum, and the appearance of pyloric obstruction, polyps can be swallowed when growing near the cardia.

Examination of gastric polyps

Those who have combined with erosion or ulcers are often tested positive for fecal occult blood or black stool.

1. Endoscopy examination under the endoscope can be seen as a round or elliptical polyp, a few lobulated, pedunculated or pedunculated, most of the diameter between 0.5 ~ 1.0cm, a few diameter greater than 2cm, adenomatous polyps color It is often redder than the surrounding mucosa, while hyperplastic polyps are similar to the surrounding mucosa. Biopsy and histological examination under endoscopic direct vision can clarify its nature and type, and can be treated at the same time.

2. X-ray examination X-ray barium meal examination showed a filling defect, which has certain value for the diagnosis of gastric polyps, but its discovery rate is lower than the gastroscope, which is suitable for contraindications for endoscopy.

Diagnosis and differentiation of gastric polyps

Gastric polyps often have no clinical symptoms, and the diagnosis is difficult. Most of them are found through X-ray gastro-intestinal fluoroscopy and gastroscopy. When the gastric polyps are inflamed, there are gastritis-like symptoms, upper abdominal pain, fullness, nausea, belching, loss of appetite. , heartburn, diarrhea, etc., polyps occur in the cardia when there is a sense of swallowing blockage, occurs in the pyloric tube, prone to pyloric obstruction or incomplete obstruction, abdominal pain and bloating aggravated with vomiting, polyps can appear when there is ulcer or cancer And hematemesis.

There are few positive signs in gastric polyps. In the upper part of the abdomen, there may be tenderness in the upper abdomen, and those with more bleeding have secondary anemia.

X-ray gastro-intestinal meal fluoroscopy and gastroscopy are the main methods for diagnosing gastric polyps. X-ray gastro-intestinal fluoroscopy shows that the circular or semi-circular boundary of the gastric cavity is neat and clear, and the surface is flat and filling defects, most of which are about 1cm in size. It can be seen that the movement is necessary for gastroscopic examination. Under the microscope, there is a circular or semi-circular bulge on the gastric mucosa, generally less than 2cm, the boundary is clear, the surface is smooth and flat, and the color is normal mucosa or bright red. Soft, pedunculated or pedunculated, single or multiple, some polyps are cauliflower-like, the surface may be erosive or ulcerated, cauliflower-like polyps and volume greater than 2cm may have malignant transformation, biopsy examination helps to identify diagnosis.

Gastric polyps are pathologically divided into proliferative and adenomatic, and the latter has a high cancer rate (30% to 58.3%). Therefore, biopsy is identified to determine the clinical treatment plan.

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