论文部分内容阅读
本文报告1例回盲部肠系膜纤维瘤诊治情况。专科查体:腹部稍膨隆、右下腹部可见一长约4cm手术瘢痕切口,全腹部压痛、以右下腹部压痛为著,并可触及一7.0cm×8.0cm大小包块,边界欠清楚。肝脾肋下未触及,胆囊未触及明显异常,移动性浊音(-),肠鸣音增强。临床诊断:(1)结肠占位;(2)不完全性肠梗阻。入院后积极完善相关化验及检查后急诊行剖腹探查术、右半结肠切除术及回肠造瘘术。术后病理学检查结果显示,部分小肠及结肠回盲部肠系膜纤维瘤,周围网膜组织慢性炎症、出血及充血;淋巴结反应性增生;结肠及回肠黏膜慢性炎症,浆膜层充血、水肿、灶性出血。术后患者恢复良好,术后第12天顺利出院;术后3个月到我院行回肠造瘘还纳术;术后1年门诊复查未见复发。
This article reports a case of ileocecal mesenteric fibroids diagnosis and treatment. Expert examination: Abdominal slightly bulging, showing a right lower abdomen about 4cm surgical scar incision, the whole abdominal tenderness, to the right lower abdomen tenderness for, and can reach a 7.0cm × 8.0cm size of the mass, the border is not clear. Liver and spleen ribs untouched, gallbladder did not touch the obvious abnormalities, mobility dullness (-), increased bowel sounds. Clinical diagnosis: (1) colon occupancy; (2) incomplete intestinal obstruction. After admission to actively improve the relevant laboratory and post-operative emergency laparotomy, right half of the colon resection and ileostomy. Postoperative pathological examination showed that part of the small intestine and colon ileocecal mesenteric fibroids, peripheral retinal tissue chronic inflammation, bleeding and congestion; reactive lymph node hyperplasia; chronic inflammation of the colon and ileum mucosa, serosa congestion, edema, foci Bleeding. Postoperative patients recovered well and were successfully discharged on the 12th day after operation. The patients underwent ileum fistula surgery 3 months after surgery. One year after the operation, no recurrence was found in the clinic.