大肠镜诊断结肠钩虫病11例报告

钩虫病（ancylostomiasis）是由十二指肠钩口线虫或（和）美洲板口线虫寄生人体引起以缺铁性贫血和营养不良为主要临床表现的疾病。钩虫成虫主要寄生于十二指肠及空肠上段，大肠钩虫病少见。2008年1月~2012年12月，我院行电子结肠镜检查14202例，检出结肠钩虫病11例，检出率0.77‰，现报道如下。     

胃镜诊断原发性十二指肠恶性瘤13例报告

原发性十二指肠恶性肿瘤比较罕见 ,易被临床医师和胃镜医师忽视。我们复习了 1989年～ 2 0 0 2年我院胃镜室作胃镜检查 396 0 0病例 ,发现由胃镜和病理学确诊的原发性十二指肠恶性肿瘤 13例 ,现报告如下 :临床资料　 (1)病例 :13例中男性 9例 ,女性 4例 ;年龄 31岁～ 6 6岁 ;平均年龄 5 5 4岁 ,5 0岁以上者 11例 ,占84 6 % ;病程 1个月～ 1年余。临床表现 :上腹部或中上部疼痛不适 8例 ,黑便 5例 ,肠梗阻 2例 ;伴黄疸 1例 ,伴上腹部包块 1例。 (2 )方法 :全部病例均使用FUJINONEG -2 0 0FP电子胃镜常规检查并取活检 ,送病理科作病理…     

老年痴呆无痛胃镜检查45例分析

老年痴呆患者处于精神亢奋或被动抑制状态,常无法配合医务人员的医疗行为,是普通胃镜检查的禁忌证。若发生误食异物、上消化道大出血等情况,可行无痛胃镜检查。2007年12月-2010年12月,我们对老年痴呆患者行无痛胃镜检查45例,效果满意。现分析报告如下。     

钩虫病误诊32例

1999年10月—2002年10月,我们收治32例钩虫病致贫血患者,因误诊,长期未得到有效治疗,为吸取教训现总结报告如下。     

十二指肠低分化腺癌漏诊1例

1病例报告患者男,37岁。因上腹部饱胀不适、呕吐酸酵宿食5个月入院。有胰腺炎病史。查体:腹平坦,上腹部未见胃型及蠕动波;腹软,无压痛及反跳痛,未触及包块,肝脾肋下未触及,移动性浊音(-),肠鸣音3～5次/min,可闻及振水音。既往胃镜检查提示:反流性食管炎,慢性浅表性胃炎,壶腹部溃疡;病理活检为胃窦黏膜慢性中度浅表性炎,壶腹部黏膜慢性炎。4个月后复查胃镜,见胃底、胃体、胃窦黏膜充血水肿,可见散在糜烂;幽门周围黏膜水肿隆起,幽门口阻塞,出口狭窄,不能进镜;病理所     

钩虫病误诊为营养不良性贫血1例

1临床资料患者,男性,63岁,系陕西汉中西乡县农民,有田间耕作史。因"头晕、乏力、间断黑便2年,腹痛半年"来我院就诊,收入消化科。患者于入院前2年出现间断黑便,伴头晕、乏力、心慌,多次在当地县医院就诊,行胃镜、肠镜检查未见异常,诊断为"营养不良性贫血",给予输血、补铁等治疗无效。     

十二指肠腺癌1例报告

<正> 病人,男,50岁。1月前无明显诱因感间歇性上腹胀痛,伴恶心、呕吐、呕血及柏油样便。查体:腹软,上腹部轻度压痛,无反跳痛;胃镜示:胃底黏膜浑浊,呈血性,胃窦部见大量暗红色血性潴留液,黏膜及幽门未显示,提示幽门梗阻。入院后先予止血、营养支持及对症治疗,然后进行手     

十二指肠溃疡并十二指肠结肠瘘五例报告

十二指肠疡并十二指肠结肠瘘是很少见的肠内瘘，本文收集5例报告如下。     

胃镜检查致贲门膜撕裂综合征8例

贲门粘膜撕裂综合征系各种原因使腹内压力或胃内压力聚增 ,引起胃贲门及食管远端粘膜和粘膜下层撕裂并出血。本文就我院胃镜检查致本病 8例进行临床分析。1　临床资料1 1　一般资料　 8例中均为男性 ,年龄 2 5～ 6 7岁 ,平均40 5岁。主因慢性上腹痛、嗳气或伴反酸行胃镜检查 ,检查前均无恶心、呕吐、呕血及黑便史。在检查过程中患者均有剧烈恶心及呕吐 ,之后出现出血 ,其中呕血 7例 ,出血量 2 0～ 5 0ｍｌ,呕血伴有黑便 1例并同时合并失血性休克 ,出血量达 3 5 0 0ｍｌ左右。1 2　诊疗经过　胃镜检查均见贲门和胃食管交界处粘膜纵形裂伤 ,…     

Heat illness. A report of 45 cases from Hong Kong

During the summer of 1985, 45 soldiers with heat illness were admitted to the British Military Hospital, Hong Kong. Twelve had severe heat stroke, the remainder heat exhaustion. This paper discusses the management and prevention of heat illness in the military context.     

Biliary ileus: preoperative diagnosis by US. A report of two cases

The preoperative diagnosis of biliary ileus was correctly made by US in two cases (87 and 80-year-old females) referred to US studies because of nonspecific abdominal symptoms and to rule out possible acute appendicitis, respectively. Plain-film findings were unremarkable in one patient, small-bowel obstruction was detected in the latter. In both cases sonography revealed a small amount of air within the thick-walled gallbladder; the presence of mechanical ileus, and a gallstone impacted within the ileal loop. These features, together with collapsed bowel lumen distally to the stone, enabled a reliable diagnosis of biliary ileus to be made. This was confirmed by ensuing laparotomy, when a large cholesterol stone was removed in both cases. Correspondence to: V. Simonovský     

子宫动脉栓塞治疗子宫肌瘤45例

目的评价经导管子宫动脉栓塞(UAE)对子宫肌瘤的疗效及影响疗效的有关因素。方法对45例子宫肌瘤患者进行超选择性子宫动脉栓塞,其中肌瘤多发36例,单发9例;肌瘤位于肌层41例(其中5例伴有子宫腺肌症,2例伴有黏膜下肌瘤);位于黏膜下4例。子宫肌瘤的诊断经影像学检查和妇科检查确定。术后超声、化验检查观察瘤体及激素水平和血红蛋白变化。结果45例患者91支子宫动脉(1例左侧为双子宫动脉)插管成功87支,成功率95.6%。45例均获随访,随访时间6～36个月。术后6个月肿瘤体积平均缩小69.3%,3例子宫肌瘤消失。贫血病例,血红蛋白升至正常。主要不良反应为下腹部疼痛和低热。结论子宫动脉栓塞是治疗子宫肌瘤的安全有效的方法。     

Imaging features of intraosseous ganglia: a report of 45 cases

The aim of this study is to report the spectrum of imaging findings of intraosseous ganglia (IG) with particular emphasis on the radiographic and magnetic resonance (MR) features. Forty-five patients with a final diagnosis of IG were referred to a specialist orthopaedic oncology service with the presumptive diagnosis of either a primary or secondary bone tumour. The diagnosis was established by histology in 25 cases. In the remainder, the imaging features were considered characteristic and the lesion was stable on follow-up radiographic examination. Radiographs were available for retrospective review in all cases and MR imaging in 29. There was a minor male preponderance with a wide adult age range. Three quarters were found in relation to the weight-bearing long bones of the lower limb, particularly round the knee. On radiographs all were juxta-articular and osteolytic; 74% were eccentric in location, 80% had a sclerotic endosteal margin and 60% of cases showed a degree of trabeculation. Periosteal new bone formation and matrix mineralization were not present. Of the 29 cases that underwent MR imaging, 66% were multiloculated. On T1-weighted images the IG contents were isointense or mildly hypointense in 90% cases. Forty-one per cent of the cases showed a slightly hyperintense rim lining that enhanced with a gadolinium chelate. Thirty-eight per cent were associated with soft tissue extension and 17% with a defect of the adjacent articular cortex. Fifty-five per cent showed surrounding marrow oedema on T2-weighted or STIR images and two cases (7%) a fluid-fluid level prior to any surgical intervention. The authors contend that it is semantics to differentiate between an IG and a degenerate subchondral cyst as, while the initial pathogenesis may vary, the histological endpoint is identical, as are the imaging features apart from the degree of associated degenerative joint disease. IGs, particularly when large, may be mistaken for a bone tumour. Correlation of the typical radiographic and MR imaging features will indicate the correct diagnosis and obviate the need for biopsy.     

脑脓肿的治疗策略(附45例报告)

目的 探讨脑脓肿的最佳治疗方案.方法 回顾性分析1999年1月-2008年3月收治的45例脑脓肿患者的临床资料,其中男34例,女11例,年龄7～76岁,平均42.6岁.单发病变40例,多发病变5例;单房性脓肿43例,多房性脓肿2例.行抗生素治疗19例,立体定向引导脓肿穿刺16例、脓肿腔穿刺引流8例,开颅手术切除脓肿5例.结果 19例接受内科保守治疗的患者中有3例凶病情加重而改为立体定向手术治疗,其余16例经内科治疗后治愈,13例在6个月～5年的随访中未见脓肿复发.24例接受立体定向手术治疗的患者(其中包括3例保守治疗失败后改行立体定向手术者)全部获得成功,1例患者术后2周因脓肿复发施行了第2次定向手术,1 例于立体定向脓肿穿刺结束时出现癫痫大发作.5例接受开颅手术的患者均完成脓肿的完整切除.出院时所有患者临床症状全部消失或明显改善,头颅CT或MRI复查显示脓肿腔消失.22例患者接受了4个月～3年的随访(平均14个月),均未见脓肿复发.结论 对于脑脓肿的治疗,应根据病情选择方案,立体定向手术可作为脑脓肿的首选治疗方法 .     

嗜铬细胞瘤的CT诊断(附4例报告)

我院经手术病理证实嗜铬细胞瘤 4例 ,现将其ＣＴ表现与鉴别诊断分析讨论如下。1　材料与方法　　 4例中 ,男 3例 ,女 1例 ,年龄分别为 38岁、49岁、61岁和65岁。临床症状主要表现阵发性高血压和头晕。原发生于肾上腺者 3例 ,肾上腺外嗜铬细胞瘤 1例。均经手术及病理证实。扫描机为ＧＦＳＹＴＥＣ - 1 60 0Ｉ型 ,平扫和增强横断扫描 ,层厚及层间距为 5 .0ｍｍ ,较大肿瘤加冠状矢状重建。2　结果　　本组报告嗜铬细胞瘤 4例 ,5个肿瘤。 3例原发生在肾上腺 (其中 1例为双侧发病 ) ,1例发生在主动脉旁肠系膜下动脉开口处。发生在肾上腺的肿瘤中 …     

双源CT诊断冠状动脉瘘2例

例1 患者女,35岁.因心慌、胸闷2月余入院.查体:心尖搏动在左第五肋间锁骨中线内侧0.5cm处,不弥散,未及明显震颤,心界增大,心率80次/min,律齐,胸骨右缘第二瓣膜区可闻及Ⅲ/Ⅳ级收缩期杂音.