医学
惠普尔病
惠普雷
惠普尔病
胃肠病学
十二指肠
胰十二指肠切除术
低色素性贫血
病态的
贫血
内科学
空肠
疾病
胰十二指肠切除术
缺铁性贫血
病理
胰腺
腹腔疾病
肠道吸收不良
作者
Shuo Chen,Yuan-Chen Zhou,Shuang Si,Hong-Yan Liu,Qing-Rui Zhang,Teng-Fei Yin,Chu-Xi Xie,Shu-Kun Yao,Shi-Yu Du
出处
期刊:World Journal of Clinical Cases
[Baishideng Publishing Group Co (World Journal of Clinical Cases)]
日期:2022-12-16
卷期号:10 (35): 13044-13051
标识
DOI:10.12998/wjcc.v10.i35.13044
摘要
Whipple's disease is a rare systemic infection caused by Tropheryma whipplei. Most patients present with nonspecific symptoms, and routine laboratory and imaging examination results also lack specificity. The diagnosis often relies on invasive manipulation, pathological examination, and molecular techniques. These difficulties in diagnosing Whipple's disease often result in misdiagnosis and inappropriate treatments.This paper reports on the case of a 58-year-old male patient who complained of fatigue and decreased exercise capacity. The results of routine blood tests indicated hypochromic microcytic anemia. Results of gastroscopy and capsule endoscopy showed multiple polypoid bulges distributed in the duodenal and proximal jejunum. A diagnosis of small intestinal adenomatosis was initially considered; hence, the Whipple procedure, a pylorus-preserving pancreaticoduodenectomy, was performed. Pathological manifestations showed many periodic acid-Schiff-positive macrophages aggregated in the intestinal mucosa of the duodenum, upper jejunum, and surrounding lymph nodes. Based on comprehensive analysis of symptoms, laboratory findings, and pathological manifestations, the patient was finally diagnosed with Whipple's disease. After receiving 1 mo of antibiotic treatment, the fatigue and anemia were significantly improved.This case presented with atypical gastrointestinal manifestations and small intestinal polypoid bulges, which provided new insight on the diagnosis of Whipple's disease.
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