普通外科罕见病二例报道

1乙状结肠系膜裂孔疝患者,男性,50岁。因“上腹部阵发性绞痛伴腹胀2+天”于2004年11月17日入我院(住院号108554)。症见:上腹部绞痛,伴腹胀,拒按,肛门停止排气排便,尿量少。体查:BP:180/75mmHg。专科情况:腹平,未见肠型及蠕动波,全腹部压痛,以右上腹尤甚,叩诊鼓音,移动性浊音(一),肠鸣音活跃,约5次/分,未闻及高音调金属音及气过水声。辅助检查:血常规:WBC:13·9×109/L,N%:84·6%,尿淀粉酶784 U/L,血淀粉酶:65 U/L,立卧位腹平片:低位性肠梗阻(梗阻平面约位于小肠末端);CT:肠梗阻并少量腹水。入院诊断:机械性肠梗阻。经过保守治疗无效后…     

膀胱罕见肿瘤两例临床报道

膀胱副神经节瘤和膀胱炎性肌纤维母细胞瘤是罕见的膀胱肿瘤。为此将临床所遇到的2例病例结合文献来共同探讨,以提高对该病的诊断及治疗水平。     

罕见男性假二性畸形报道一例

患者13岁,“女”,以发现双侧腹股沟区可复性肿物6年为主诉入院。 查体：双侧腹股沟区分别可触及一肿物,约2.0×3.0厘米,质软，边界清，可还纳，外阴呈女性，肿物还纳不完全，压内环试验：阴性。     

罕见畸胎一例报道

畸胎儿之母子１９９６年９月１２日入本院，足月待产。于次日凌晨一时三十分生下畸胎，为男性。生后皮肤颜色正常，哭叫，但声音不大。生后查体：男婴身长４９ｃｍ，平伸双臂宽大约４５ｃｍ体重５公斤。该婴脐带处又长出一个头颅，此头颅比正常头颅体积大两倍，头颅触之软，有浮动感．生有头发没长眼睛，但在眼的位置处有两眼的痕迹，无眼球；双耳位置也只有耳的痕迹，没有耳廓和耳道；口部有一个５ｃｍ×５ｃｍ的洞穴，无唇，在洞的边沿上长有两个口齿，触之坚硬。头下长有一个长７ｃｍ、粗３ｃｍ的软组织与脐相连。该组织柔软、有血管搏动…     

超声诊断腹腔肿瘤二例报道

由于受肠道气体的影响 ,腹部超声的敏感性较差。但只要细致耐心 ,多途径检测 ,也可以清楚地显示病灶。本科超声诊断双侧卵巢良性占位和肠道肿瘤致肠套叠各 1例 ,报道如下。病例 1　 2 4岁 ,孕 12周余 ,因右下腹疼痛来院做超声检查。子宫及胎儿正常 ,右侧卵巢明显增大 ,约 8ｃｍ× 7ｃｍ× 5ｃｍ ,形态不规则 ,并可见 2枚中等偏高回声光团 ,约 3ｃｍ× 4ｃｍ、2 .5ｃｍ× 2 .4ｃｍ ,前缘边界清楚 ,后方有声衰减 ;另在左侧卵巢发现 1枚高回声光团 ,约 4ｃｍ× 3.6ｃｍ ,边界清 ,内部光点分布尚均匀。肿块内均未见彩色血流。后穹隆内未见明显液…     

超声诊断腹腔肿瘤二例报道

由于受肠道气体的影响,腹部超声的敏感性较差。但只要细致耐心,多途径检测,也可以清楚地显示病灶。本科超声诊断双侧卵巢良性占位和肠道肿瘤致肠套叠各1例,报道如下。 病例1 24岁,孕12周余,因右下腹疼痛来院做超声检查。子宫及胎儿正常,右侧卵巢明显增大,约8cm×7cm×5cm,形态不规则,并可见2枚中等偏高回声光团,约3cm×4cm、2．5cm×2．4cm,前缘边界清楚,后方有声衰减;另在左侧卵巢发现1枚高回声光团,约4cm×3．6cm,边界清,内部光点分布尚均匀。肿块内均未见彩色血流。后穹隆内未见明显液体(图1)。超声诊断：双侧卵巢良性占位,右卵巢轻度扭曲。定期随访至妊娠足月,行剖腹产,见双卵巢肿块均由毛发和脂肪组成。病理诊断：双侧卵巢畸胎瘤。     

肾上腺囊肿7例报道

肾上腺囊肿７例报道上海医科大学附属华山医院泌尿外科姚孟树，宋建达，沈家立肾上腺囊肿在肾上腺疾病中是较为少见的一种疾病。常为体检或检查其他疾病时发现。我院自１９７２年～１９９３年间收治７例，现报告如下。临床资料女性６例，男性１例，年龄３５～３９（平均３...     

肾上腺囊肿1例报道

1临床资料 　　患者女性, 25岁。因左侧腰部间歇性钝痛 2年,乏力 2个月入院。外院 B超检查怀疑为脾囊肿。无高血压及肥胖病史。体检：发育正常,血压： 17/12kPa,左肾区叩击痛。 B超示左肾上极囊性占位, 5.5cm× 5.1cm× 4.6cm大小,边界清。 CT示左肾上腺区域见一椭圆形低密度影, CT值 22HU,边界清 (图 1)。右肾上腺正常。血、尿生化检查正常。 IVU示左肾上极受压,肾下移。诊断为左肾上腺囊肿。在硬膜外麻醉下行经腰左肾上腺囊肿切除术。术中见左肾上腺部位一囊性肿物,有完整包膜,表面附有萎缩的肾上腺组织,肿物大小与术前 …     

肾上腺危象一例报道

原发性慢性肾上腺皮质机能减退症,又称阿狄森病(Addison's disease),临床上较少见,发生危象时容易误诊。兹报告一例:患者女性,40岁,住院号164926。因乏力、皮肤变黑二年,腹痛、腹泻呕吐18天于1986年10月13日转入我院。患者于1984年起常感头晕、乏力、厌食,逐渐出现面部、手足背侧皮肤变黑。二年来体重减轻15公斤,上述症状日渐加重,以致卧床不起。86年9月     

罕见白血病二例

组织细胞白血病和浆细胞白血病都是罕见的白血病,本科通过光学显微镜白血病细胞形态学和简单组化染色鉴别,发现各1例,现报告如下。病例报告　　例1:男,12岁,急性病客,面色苍白伴发热近1个月入院。查体:急性病客,贫血貌,两肺呼吸音粗,未见罗音,肝脾未触及。血液学检查:Ｈｂ33ｇ/Ｌ,ＲＢＣ1.33×1012/Ｌ,ＰＣＴ27×109/Ｌ,Ｎ0.071,Ｇ0.092,Ｌ0.837,ＷＢＣ2.4×109/Ｌ。骨髓像:增生明显活跃,粒、红、巨核三系严重受抑制,全片淋巴仅占6%,可见异常组织细胞增生旺盛占94%,细胞大小不一,有的体积明显增大呈巨细胞,形态多样,畸形显著,多有伪足状突起…     

罕见膀胱结石二例

<正> 例1 刘×,男,40岁,工人。因腰痛、排尿困难、伴尿频、尿急、尿痛加重4天入院。时有尿线中断,但无脓血及发冷发烧。上述症状反复发作十余年,当地医院诊断为“泌尿系感染”。每次发作经消炎对症治疗均可缓解。体检:一般状况尚佳。表情痛苦。心肺及腹部理学检查均正常,两肾区叩击痛(-),除肛诊前列腺稍大外,余无异常发现。检查:尿常规:蛋白(?)、红细胞5-10/低倍视     

罕见核型二例

罕见核型二例夏建川，吕军华，刘菲予，俞剑飞，杨晓宁（生物遗传学教研室生物遗传学电教室赣州３４１０００）例１先证者，男，３８岁，因生一女患软骨发育不全来我室就诊，体检未见异常，否认有近亲婚配史。人体外周血淋巴细胞染色体Ｇ显带分析，核型为４６，ＸＹ，ｉｎ...     

罕见盆腔巨大肿瘤手术治疗成功二例报告

我院自1977年以来,10年中遇两例少见巨大盆腔多发性恶性许旺氏细胞瘤和巨大前列腺样腺瘤各一例,手术切除成功,治愈出院,报道如下。 例1:谭×,男,48岁,以下腹巨大包块自1977年5月19日突然畏寒、发热,体温38～39℃,出现尿     

罕见巨大膀胱结石1例报道

患者,男,52岁,农民,已婚,因下腹部胀痛可扪及一圆形硬性包块伴尿频、尿急、尿痛而入院。患者从6岁开始有尿频、尿急、尿痛症状,服中草药后症状能缓解。每年发病3次左右,发病时间为夏、秋季节。患者40岁以后每年发病次数增多。近1年来自觉下腹部有坠胀感,尿频、尿急、尿痛症状严重,有时走路也觉得下腹部沉重感。来我院门诊就诊,收入外科治疗。入院检查:心肺功能正常,下腹部     

肾上腺囊肿二例

例１　女性,３５岁,以间歇性头晕、恶心半年入院。体检：血压１０５／６０ｍｍＨｇ。静脉肾盂造影提示右肾盂占位性病变,右侧逆行肾盂造影未见明确病变。Ｂ超示左肾上方可见３６ｃｍ×２８ｃｍ、２０ｃｍ×１８ｃｍ低回声形态,多考虑实性占位性病变。ＣＴ示肾上腺腺瘤。于入院后两周在硬膜外麻醉下行“左侧肾上腺包块探查术”。见左侧肾上腺内上方有３５ｃｍ×３０ｃｍ及３０ｃｍ×２０ｃｍ大小两个囊肿,壁透亮,极薄,下极有肾上腺组织附着,放出囊液后,将大部分囊壁予以切除。病理诊断：左肾上腺囊肿伴球状带增生。…     

罕见小肠囊腺瘤1例报道

SUMMARY In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.     

罕见肾上腺巨大血管瘤致高血压1例

患者,女,59岁,2015年10月20日因摔伤后出现腹部疼痛伴纳差于当地医院行腹部CT平扫提示:左侧肾上腺区巨大占位性病变.既往有高血压病史4年,呈持续性,最高血压180/110 mmHg,口服硝苯地平治疗,血压控制在160/100 mmHg,实验室检查均未见异常,全腹CT平扫+三期增强(图1):左侧肾上腺区见一较大低密度影,大小约16.0 cm×14.0 cm×25.0 cm,CT值约18~80HU,内部及外缘见不规则形高密度影,囊壁见壳状钙化,增强扫描强化不明显.     

罕见小肠囊腺瘤1例报道

SUMMARY In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.     

肾上腺结核误诊为肾上腺肿瘤2例

1 临床资料 例1 男,56岁.因全身皮肤发黑,乏力、消瘦1年,加重半月入院.查体:表情淡漠、全身皮肤色素沉着,尤以面部、颈部、手背、双下肢、阴茎着色明显.心肺听诊正常.