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1 临床资料患者女性,43岁。因上腹隐痛不适2个月加重伴腹泻半个月于1993年5月11日入院。入院后作纤维结肠镜检查发现横结肠肿瘤,胃镜检查未发现溃疡及新生物。B超检查:结石性胆囊炎,胆囊充盈,肝脏无异常。Hb53g/L,WBC 7.6×10~9/L,N 0.86,大便隐血(+),拟行横结肠切除加胆囊切除。 1993年5月16日在硬膜外麻醉下行手术治疗。术中发现:腹腔内有淡黄色渗出液1000ml左右,横结肠中段有一直径10cm大小的肿块,质硬,已浸润肠壁全层和大网膜。胃角小弯侧有一5cm×5cm×4cm的肿块,质硬,已浸润至浆膜层,小弯肿块附近有一1cm大小的淋巴结,质硬。右侧卵巢有一1cm大小的囊肿。胆囊肿大约10cm×5cm×5cm,“鹅颈”有一2cm大小的结石嵌顿。行胃癌根治性切除,横结肠切除,胆囊切除,右卵巢囊肿切除。术后病检报告:胃中分化腺癌伴
1 Clinical data Patient female, 43 years old. Due to upper abdominal pain discomfort increased in 2 months with diarrhea half a month on May 11, 1993 admission. After admission for colonoscopy found fibroids, colonoscopy found no ulcers and neoplasms. B-ultrasound: calculous cholecystitis, gallbladder filling, no abnormal liver. Hb53g / L, WBC 7.6 × 10 ~ 9 / L, N 0.86, fecal occult blood (+), to be performed transverse colon resection plus cholecystectomy. May 16, 1993 under epidural anesthesia surgery. Intraoperative findings: the peritoneal light yellow exudate about 1000ml, transverse the middle of a diameter of 10cm in size mass, hard, has infiltrated the full thickness of the intestinal wall and the omentum. Small corner side of the stomach corner of a 5cm × 5cm × 4cm mass, hard, has infiltrated to serosa, small lumps near the size of a 1cm lymph nodes, hard. Right ovary has a 1cm size cysts. Gallbladder about 10cm × 5cm × 5cm, “gooseneck” has a 2cm size stone incarceration. Radical resection of gastric cancer, transverse colon resection, cholecystectomy, right ovarian cyst excision. Postoperative pathological examination report: gastric adenocarcinoma with differentiation