论文部分内容阅读
患者女性,46岁。患者约半年前无明显诱因自觉大便次数增多,无明显消化道不适症状,无便血、胸闷、心慌、咳嗽、咳痰,既往有子宫手术切除史7年余。查体:全身皮肤黏膜无黄染、出血点,浅表淋巴结未触及;腹平软,未见腹壁静脉曲张及肠型,下腹部可见陈旧性纵行手术瘢痕,约5 cm。腹壁柔软,无压痛、反跳痛及肌卫,未及异常包块,肝、脾肋下未及,莫非征阴性。肠镜示末端回肠至升结肠处见巨大新生物,蒂较宽,占据肠腔1/2(图1)。考虑诊断:回盲部黏膜下巨大肿瘤,性质待定。行回盲部切除术,术中见病灶位于回盲部升结肠,为1枚带蒂、质软肿物,大小约5 cm×4 cm×
Patient female, 46 years old. About six months ago, patients had no obvious incentive to consciously increase the number of stools, no obvious symptoms of gastrointestinal discomfort, no blood in the stool, chest tightness, palpitation, cough, expectoration, past history of uterine surgery more than 7 years. Physical examination: systemic skin and mucous membranes without yellow dye, bleeding, superficial lymph nodes not touched; abdominal soft, no abdominal varicose veins and intestinal type, the lower abdomen visible old longitudinal surgery scar, about 5 cm. Abdominal wall is soft, no tenderness, rebound tenderness and myo-Wei, not as anomalous mass, liver, spleen and ribs did not, is not negative sign. Intestinal endoscopic ileum ascending colon to see a huge new creature, pedicle wider, occupy the intestinal lumen 1/2 (Figure 1). Consider the diagnosis: a large submucosal ileocecal tumor, to be determined. Line of ileocecal resection, intraoperative see the lesion in the ileocecal ascending colon, a pedunculated, soft mass, size of about 5 cm × 4 cm ×