右腹股沟膀胱憩室疝1例报告

我院于1999年4月收治右腹股沟膀胱憩室疝一例，现报告如下：     

膀胱憩室内翻伴腹内疝1例

患者男，４６岁。突然腹部胀痛，阵发性加剧伴有恶心呕吐１０ｈ张训民，男，５９岁，主治医师，灵璧县医院外一科，２３４２００安徽省灵壁县吕洪波，通讯地址同第一作者于１９９８年２月２０日急诊入院。体查：中腹部及下腹部压痛，反跳痛不明显，可见肠型，可闻及气过水...     

膀胱憩室为疝内容物的腹股沟斜疝一例

小儿腹股沟斜疝发病率为0．8％～4．4％,男女比例为15：1,左侧占25％。女童的腹股沟斜疝内容物可有膀胱、子宫、附件,并能形成疝囊壁的一部分,但膀胱憩室为疝内容物的罕见。我们收治一例此患者现报告如下。     

左腹股沟直疝疝囊突入阴囊伴膀胱疝入1例报告

患者 ,男 ,65岁 ,因左腹股沟可复性包块 9年 ,尿潴留 1天入院。入院前 9年因用力不当致左下腹受伤 ,随即左腹股沟出现一指头大小包块 ,并逐年长大 ,包块劳动时下坠 ,平卧时回缩。两天前下地劳动时感下腹部剧痛难忍 ,并感排尿困难、腹胀 ,2 4小时未解小便 ,在当地村卫生站给予利尿药后病情加重而来本院治疗 ,经导尿 10 0 0ｍｌ后疼痛仍未缓解 ,当向上推阴囊包块 (约 2 0ｃｍ×2 0ｃｍ大 )后 ,从导尿管引流出血性尿液 5 0 0ｍｌ。查体 :Ｔ 3 7.6℃ ,Ｐ 80次 /分 ,Ｒ 2 5次 /分 ,ＢＰ 2 1/16ｋＰａ(160 /12 0ｍｍＨｇ) ;腹部未见肠型 ,肝脾未扪…     

膀胱憩室小细胞癌1例

患者,男,84岁。因间歇无痛性肉眼全程血尿3个月,加重伴乏力,尿痛1周,于2009年6月14日入院。患者3个月前出现肉眼血尿,为全程无痛性,1周前上述症状加重,伴乏力,尿痛,无发热、盗汗、消瘦及腰腹部疼痛。患者既往排尿困难7年,未系统治疗。体检：耻骨上区偏左可触及约8cm×9cm囊性包块,光滑,压痛不明显。肛门指诊前列腺Ⅱ度大,质韧,未触及质硬结节,中央沟消失。     

膀胱憩室癌5例报告

目的：探讨膀胱憩室癌的临床特征，提高其诊治水平。方法：对5例膀胱憩室癌患者均行CT和膀胱镜检查确诊。3例行根治性膀胱全切、尿流改道手术．2例行膀胱部分切除术。结果：病理诊断移行细胞癌2例，鳞状细胞癌2例，恶性神经鞘瘤1例。3例于术后2个月内死亡，均为非移行性细胞癌；另外2例术后随访10个月，无局部复发和远处转移。结论：CT和膀胱镜检查是确诊膀胱憩室癌的重要方法；膀胱憩室癌的临床分期不同，预后明显不同，非移行细胞癌病理类型有早期浸润行为．预后差。     

巨大胃憩室1例

巨大胃憩室１例谭卫龙女，５６岁。入院前３年间竭性上腹不适、吐酸、嗳气；半年前发现上腹部鸭蛋大肿块；２天前突然呕吐咖啡色伴有血块之液体约６００毫升，排柏油色大便３次，总量约为１０００毫升而急诊入院。体查：Ｔ３９℃，Ｐ１１６次／分，Ｒ２４次／分，ＢＰ１０...     

巨大膀胱憩室癌并多发结石1例

膀胱憩室癌国内报道不多，而巨大膀胱憩室癌伴多发结石更少见。我院近期收治1例，报告如下。     

膀胱充盈腹股沟直疝术中未找到疝囊2例

1　病例报告　例 1　男 ,5 2岁。发现右腹股沟部直疝 5年入院 ,无排尿不畅史。B超检查前列腺无肥大 ,残余尿 80ml ,术前准备后择期手术 ,术中反复在Hesselbach三角、精索内寻找疝囊均未能找到 ,嘱患者增加腹压包块不能突出。最后于腹股沟管后壁触腹部 ,发现膀胱底部达脐下一横指 ,张力大 ,即给予导尿 ,排出尿量 60 0ml后 ,嘱患者咳嗽可见腹股沟管后壁囊性包块隆出 ,即找到疝囊 ,见腹壁下动脉位于腹环外侧 ,行充填式无张力疝修补术。例 2　男 ,2 6岁。发现左腹股沟直疝 7年入院。予以手术治疗。术中 1h内未能找到疝囊 ,嘱患者咳嗽增加腹压无…     

疝内容物为粘液瘤1例

患者　男 ,6 5岁。因右腹股沟区可纳性包块 1年 ,不能回纳伴疼痛 3ｈ入院。体查 :腹部稍膨隆 ,腹水征 (± ) ,右腹股沟区可见一约12ｃｍ× 9ｃｍ× 5ｃｍ大小肿物 ,肿物约有 1/3进入阴囊内 ,有触痛 ,平卧后不能回纳入腹腔。诊断 :右腹股沟嵌顿性斜疝。入院后即予手术 ,术中切开疝囊时 ,即有大量的胶冻样液体溢出 ,疝囊内有一约8ｃｍ× 6ｃｍ× 4ｃｍ大小的胶冻样肿物 ,与大网膜相连 ,将其切除送病检。从疝囊颈探查腹腔 ,腹膜脏面布满大小不等的肿物。行疝囊高位结扎及ＭｃＶａｙ法修补术。切口用大量生理盐水及 5 氟脲嘧啶冲洗。术后患者拒…     

Vesical actinomycosis: a case report

A 55-year-old woman had complained of lower abdominal pain for 5 years. A computed tomographic CT scan and magnetic resonance imaging revealed a heterogeneous density mass on the left side of the bladder. CT-guided needle biopsy showed only inflammatory cell infiltration without histological diagnosis. To confirm the diagnosis, the mass was resected together with part of the bladder and peritoneum. On the cut surface, the mass was centrally pale yellow and adherent to the thickened hard wall of the bladder and peritoneum. Pathological diagnosis was chronic granulomatous inflammation with actinomycosis. This is, to our knowledge, the 12th case report of vesical actinomycosis in Japan. Although actinomycosis is very rare in urological field, abdominal actinomycosis should be considered as the differential diagnosis of any inflammatory abdominal mass.     

门脉高压致膀胱静脉曲张一例报告并文献分析

目的 提高对门静脉高压所致膀胱静脉曲张临床诊治特点的认识. 方法 患者男,63岁.间断无痛性全程肉眼血尿7个月入院.既往肝硬化病史9年.查体未见阳性体征.实验室检查血小板56×109/L.超声检查示脾大(5.8 cm×14.0 cm);膀胱左侧壁和前壁可见一内部充满静脉血流信号的网状结构(7.0 cm× 2.4 cm),向膀胱左侧外上方延伸,与一粗大静脉血管相连.膀胱镜下可见左侧壁和前壁的曲张静脉血管(3.0 cm×5.0 cm).CT血管重建检查示膀胱曲张血管与肠系膜下静脉相连,最终汇入脾静脉.患者临床诊断为肝硬化、门静脉高压、膀胱静脉曲张.行膀胱周围血管离断术治疗. 结果 患者手术过程顺利,术后血尿症状消失,1个月后复查超声膀胱结构正常. 结论 肝硬化门静脉高压患者可发生膀胱静脉曲张,膀胱周围血管离断手术治疗效果满意.     

Perforated caecal diverticulum as a content of inguinal hernia — report of a rare case

A tablet induced perforation of a caecal diverticulum into a hernial sac is a rare happening. The report discusses the presentation and outcome of a patient with such an unusual disease. A 55-year-old man presented with features of irreducible right sided indirect inguinal hernia. A hard swelling near upper pole of right testis was noted. Scrotal ultrasound revealed a normal testis. At operation caecum and proximal ascending colon were found in the hernial sac with the caecum adherent to the testis. As caecal malignancy could not be ruled out and enbloc Rt Haemicolectomy with Rt orchidectomy was performed. The patient had an uneventful recovery. Pathological examination of the specimen revealed a perforated caecal diverticulum with presence of multiple tablets in its lumen invaginating the upper pole of right testis without any evidence of malignancy. Tablet induced perforation of a caecal diverticulum into a hernial sac is a rare clinical entity. If malignancy cannot be negated at operation, a right haemicolectomy is a safe and feasible option.     

白线Richter疝误诊1例

患者　女 ,61岁。 3年前无意发现上腹壁正中有一肿块 ,大小无明显变化。因肿块增大 ,持续性疼痛 ,伴恶心、呕吐 1ｄ入院。体查 :体温 37 5℃ ,脉搏 82次 /ｍｉｎ ,血压1 61 /90ｍｍＨｇ。脐上白线处触及 3ｃｍ×3ｃｍ包块 ,质软 ,轻度压痛。腹部无压痛、反跳痛、肌紧张、肠鸣音正常。白细胞 1 4 4× 1 0 9/Ｌ ,中性粒细胞 0 82。腹部平片 :未见液平面及膈下游离气体。入院诊断 :上腹壁脂肪瘤并感染。经抗生素治疗 2ｄ ,肿块处疼痛逐渐加重 ,且局部皮肤红肿 ,明显压痛。术前诊断 :白线疝嵌顿 ,即行手术治疗。术中见 :腹白线有一 1 5ｃｍ缺…     

两性畸形并子宫、附件疝1例

患者男,54岁.农民,因右阴囊可复性包块右斜疝入院.体检:右阴囊包块10cm×8cm,平卧后大部分疝内容物能还纳腹腔,阴囊内可扪及正常大小睾丸,但附睾、精索不清,腹股沟处可触及约5cm×5cm囊实性包块.     

Multiple ureteral diverticula: a case report

A 73-year-old male was admitted to our hospital with the complaint of difficulty and frequency of urination. Needle biopsy of the prostate was done and microscopic examination revealed adenocarcinoma. Bone scintigram showed multiple bone metastasis and he was diagnosed as having prostatic carcinoma stage D2. Intravenous pyelography revealed multiple out-pouching lesion of mid left ureter and left mild hydronephrosis. Fosfestrol was given for prostatic carcinoma and no treatment was given for multiple ureteral diverticula. Sixteen cases of multiple ureteral diverticula from Japan were collected and discussed.     

十二指肠旁疝合并肠扭转1例

患者　女,46岁,因脐周阵发性绞痛,伴恶心、呕吐、肛门排气停止1ｄ,加重6ｈ入院。体查:痛苦面容。腹胀,全腹压痛,反跳痛,以上腹部为著,移动性浊音阳性,肠鸣音减弱。血红蛋白120ｇＬ,白细胞12×109Ｌ,中性粒细胞076,腹部透视可见两处液平。诊断:肠梗阻,原因待查。即行剖腹探查术,术中见腹腔内有200ｍｌ血性渗液,大部分小肠呈暗紫色,顺时针方向扭转约720,吸尽渗出,将扭转小肠复位后,发现升结肠游离,距回盲部约20ｃｍ处有长约35ｃｍ的回肠及约30ｃｍ的空肠上部肠管疝入并嵌顿于小肠系膜左侧之腹膜囊内,囊口直径约45ｃｍ,局部见瘢痕增生。打开腹…