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目的探讨原发性十二指肠癌(PDC)的临床特点及诊治措施,以减少误诊。方法对1例诊断为肠系膜上动脉压迫综合征的原发性十二指肠癌患者的临床资料进行回顾性分析。结果患者临床表现为上腹胀、恶心、呕吐、呕吐后腹痛缓解等较为典型的肠系膜上动脉压迫综合征表现,上腹部增强CT提示腹主动脉各主要分支结构正常,肠系膜上动脉及腹主动脉间夹角较小,约26°左右,考虑肠系膜上动脉压迫综合征。腹部MRI提示考虑小肠肿瘤伴肠系膜扭转或腹内疝。精做胃镜提示十二指肠环下方环腔黏膜见深凹溃疡,病检提示腺癌。结论提高对PDC的警惕性,积累与其他消化道疾病鉴别的经验,避免PDC的误诊,早发现、早诊断、早手术是治疗的关键。
Objective To investigate the clinical features and diagnosis and treatment of primary duodenal cancer (PDC) to reduce misdiagnosis. Methods The clinical data of one patient with primary duodenal cancer diagnosed as superior mesenteric artery syndrome were analyzed retrospectively. Results The clinical manifestations of patients with upper abdominal distention, nausea, vomiting, abdominal pain relief after vomiting and other typical symptoms of superior mesenteric artery syndrome, enhanced abdominal CT showed that the main branches of the abdominal aorta normal structure, between the superior mesenteric artery and abdominal aorta Angle is small, about 26 °, consider the superior mesenteric artery compression syndrome. MRI of the abdomen suggests that small intestine tumors may be associated with mesenteric or intra-abdominal hernia. Gastroscope Tip Endoscopic duodenal ring cavity deep mucosal see ulcers, pathological examination prompted adenocarcinoma. Conclusions It is necessary to improve the alertness of PDC and accumulate experience with other gastrointestinal diseases to avoid misdiagnosis, early detection, early diagnosis and early surgery of PDC.