9例肠系膜囊肿临床分析

通过回顾性地分析我院１９７０－１９９５年间收治的９例均经手术和病理证实肠系膜囊肿病例，临床表现以腹痛和腹部包块为主，部分包块活动度较大。腹部Ｂ超和ＣＴ有利确诊。治疗应完整切除包块，预后良好。     

小儿肠系膜囊肿一例

<正> 肠系膜囊肿是一种少见的疾病,诊断比较困难,常和腹腔其它脏器的肿块难以鉴别,笔者遇见一例,经手术,病理证实,报告如下: 男,4岁,其母代述,2个月前扪及腹部发现有一包块,鸡蛋大,近一个月包块增大迅速,腹痛,食欲不振,呕吐入院。查体:T37.2℃,R24次/分,P94次/分,BP11.0/8.0Kpa。发育正常,双肺呼吸音清,心脏听诊无杂音。腹部膨隆,腹正中偏右可触及13×9.0cm大包块,质软,边缘整齐,表面光滑,无触痛,     

五例肠系膜囊肿临床分析

近 15年来 ,我院收治了 5例肠系膜囊肿 ,现结合临床资料对其诊治分析如下。1　临床资料1)　一般资料 :本组 5例 ,男 1例 ,女 4例 ,年龄 3～ 35岁 ,平均年龄 13.36岁。2 )　临床表现 :均因发现腹部包块就诊。腹胀、腹痛 3例 ,消瘦、乏力 1例 ;发热、贫血及肠梗阻表现 1例。体检时扪及腹部有活动性、无压痛、质地呈囊性感包块。除三大常规、血生化检查外 ,均常规Ｂ超检查 ,提示 :腹腔囊性包块。术前均明确诊断为肠系膜囊肿。一例因不完全性肠梗阻行全消化道钡餐检查 ,提示 :小肠受压。3)　治疗 :经完善的手术准备 ,均行囊肿摘除术。其中囊肿分…     

肠系膜囊肿26例分析

肠系膜囊肿是一种临床少见疾病，好发于１４岁以下儿童，男性多见。本文收集了我院１９７０年６月至１９９８年６月住院病人共２６例，均经手术切除和病理证实，现报告并讨论如下：１　临床资料１．１　一般资料：本组２６例患者中，男２０例，女６例（男女比例１０∶３）。年龄最小为６个月，最大者３３岁，多发于６个月至１４岁儿童，以８岁以下儿童为著，成人偶见。１．２　临床表现：单纯腹痛１０例，腹痛伴腹胀８例，单纯呕吐４例，单纯腹泻４例，腹部膨隆２０例，扪及腹部包块者１８例，Ｂ超检查时发现：合并肠套叠２例，肠扭转３例，…     

肠系膜巨大平滑肌肉瘤3例

肠系膜巨大平滑肌肉瘤３例重庆已南区人民医院（６３１３２０）杨正辉，徐庭伟例１，女，６１岁。因左上腹包块５月于１９９３年７月２６日入院。查体：贫血貌，浅部淋巴结不肿大。左上腹部触及１５ｃｍＸ１０ｃｍＸｓｃｍ质中包块，表面光滑，边界清楚，轻触痛，可推动。...     

先天性巨大肠系膜囊肿1例围手术期护理体会

<正>1病例介绍患者,女,6岁。患儿母亲发现其腹部包块约6个月,进食后饱胀,无发热黄疸,饮食及二便正常,于入院前4d开始,腹痛、腹胀剧烈,伴恶心、呕吐胃内食物、尿频、尿急,于2008年     

儿童肠系膜囊肿的外科处理

肠系膜囊肿 (Ｍｅｓｅｎｔｅｒｉｃｃｙｓｔ)又称肠系膜淋巴管囊肿 (ＭｅｓｅｎｔｅｒｉｃＬｙｍｐｈａｎｇｉｏｍａ) ,是很少见的小儿腹部肿瘤 ,多在 3至 10岁时出现症状 ,由于临床表现不同 ,往往造成诊断困难。 1989年 4月至 2 0 0 1年 12月我们收治小儿肠系膜囊肿 8例 ,报告如下。1　临床资料1.1　一般资料 :男 3例 ,女 5例。年龄 7个月至 12岁 ,其中 1～ 3岁 2例 ,4至 12岁 6例。患儿发育营养状况均良好。临床表现腹部膨隆、腹部包块伴或不伴发热 3例 ;腹痛伴呕吐 4例 ;腹部受伤后腹痛伴呕吐、发热 1例。均急诊入院。1.2　影像学检查 :8…     

小肠系膜巨大淋巴管囊肿1例报告

1病历摘要 患者男26岁，因腹部肿物10d而入院。患者缘于10d前，无明显诱因。无意中发现腹部包块，前来我院就诊。经门诊检查后，诊断为腹腔多发性肿物。病程中无腹胀、腹痛，无恶心、呕吐，食欲良好，无尿频、尿急及排尿困难等压迫症状。查体：患者一般状况良好，心肺未见异常。腹部平坦，未见肠型及肠蠕动波。肝脾不大。右上腹部可扪及6．Ocm×5．0cm大肿物，活动尚可，界限不甚清，质韧，无明显触压痛，左上腹可扪及4．Ocm×3．0cm大的肿物，界限不清，右下腹可扪及10．0×6．0cm大管状肿物，质韧，界限尚清，活动尚可，无触压痛，腹部叩诊无移动性浊音，肠鸣音正常。彩色多普勒超声示：腹部多处囊性占位性病变，不除外粘液性囊腺瘤。腹部CT扫描示：腹腔多发性囊性占位性病变，病变与肝、胆、脾、胰、肾无联系。     

肠系膜上动脉结扎术2例

例1:男,68岁,系因上腹膜包块伴腹胀半年入院。查体:上腹部可触及直径约为16 cm的包块,活动度差,质中,无压痛。剖腹探查见腹膜后横结肠系膜根部有16cm×16cm×18cm包块,包绕肠系膜上动脉静脉。术中速冻切片,诊断为脂肪肉瘤。术中先行暂时阻断肠系膜上动静脉,并观察30min,发现仅有1.4cm的小肠供血不良,故决定行整块瘤体及肠系膜上动静脉切除术,并行供血不良的小肠约1.4cm切除,剩余肠管端端吻合,术后痊愈出院。例2:女,54岁,因中腹部包块4月余入院。查体:中腹部可触及16cm×10cm×10cm包块、活动度差、质中。术中探查,肿块位于胰腺下沿,从横结肠…     

巨大胰腺假性囊肿1例

1 病例介绍 患者,女,39岁.因发现上腹部无痛性包块2年入院.患者2年前偶然发现上腹部一包块,并进行性增大,平时无明显自觉症状,无腹胀、腹痛,无恶心、呕吐、黄疸等不适,未行任何处理.既往否认胆囊结石,胰腺炎病史,否认上腹部手术史及外伤史.查体:血压110/70 mm Hg,脉搏78次/分,巩膜无黄染,心肺听诊未闻及异常,上腹部正中稍右可触及一约14 cm×12 cm大小包块,表面光滑,边缘尚清,活动欠佳,有囊状物感,无明显压痛.     

A gossypiboma masquerading as a mesenteric cyst

Gossypiboma refers to foreign bodies left inside the body during surgery, such as sponges and gauze. These foreign bodies represent a significant cause of morbidity and mortality.A 57-year-old female presented to us with right upper abdominal pain. Her past history was non-contributory except for an open cholecystectomy 20 years previously. A physical examination revealed tenderness to palpation on the right of the abdomen, while the remaining examination was normal. An abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scan revealed a well-defined calcified mass of 5 cm that was compatible with a mesenteric cyst. During surgery, the mass was found to be adherent to the mesocolon and to have invaded the colon wall. A right hemicolectomy and ileotransverse anastomosis was performed. The pathological mass was considered to be a gossypiboma that had been left behind during the earlier cholecystectomy. The body''s reaction to the foreign body was seen to extend beyond the lamina propria and muscularis propria.Gossypiboma is an undesired and life-threatening but preventable surgical complication. This condition may present with non-specific findings and a clinical scenario that mimics various disorders, even after many years. A diagnosis of gossypiboma should be kept in mind for patients with a history of previous operations and undergoing surgery due to the suspicion of a mesenteric cyst.     

新生儿先天性胆总管囊肿的特点及外科处理

本文报告３例新生儿先天性蛆总管囊肿，均女孩手术时日龄４９ｄ，３４ｄ和３８ｄ。主要临床表现有黄疸，陶土色大便和右上腹包块。Ｂ超显示右上腹囊性包块。１例作Ｒｏｕｘ－ｅｎ－Ｙ肝肿－空肠吻合，２例人生中肿切除，Ｒｏｕｘ－ｅｎ－Ｙ肝总管一空肠吻全，３例均治愈。     

经阴道与经腹部超声诊断卵巢囊肿蒂扭转的对比性分析

目的探讨经阴道超声对卵巢囊肿蒂扭转的诊断价值。方法对47例住院病例经手术证实为卵巢囊肿蒂扭转的超声检查结果进行回顾性分析,对比分析经阴道与经腹部超声检查结果,并与手术结果及病理结果进行对照。结果47例超声检查均能发现卵巢肿块,其中经阴道超声检查24例,发现扭转蒂部21例,准确率87．5％,3例因肿块巨大（平均直径〉10cm）未能发现扭转蒂部后经腹部检查发现,经腹部超声检查26例,发现扭转蒂部18例（包括经阴道超声检查漏诊的3例巨大肿块）,准确率69．2％。结论超声对卵巢囊肿蒂扭转具有诊断价值,经阴道超声检查在中等大小或偏小的卵巢囊肿蒂扭转诊断中具有优越性,在巨大的卵巢囊肿蒂扭转中经阴道结合经腹部检查诊断价值更高。     

彩色多谱勒高频超声对小儿急性肠系膜淋巴炎的诊断

目的采用彩色多谱勒高频超声对腹痛的患儿进行肠系膜淋巴结检查。方法对52例急性腹痛的患儿和19例对照组的儿童进行腹部“品”字形的超声检查,观察记录淋巴结分布密度、部位、形态回声、测量长短径比(L/S)。结果腹痛组有95%(49/52)显示淋巴结肿大,为密集型或串珠状分布,右侧腹部淋巴结肿大的程度比脐上部和左侧腹部明显。腹痛组淋巴结长短径均大于对照组(P<0.05),而两组淋巴结长短径之比>2.0。结论彩色多谱勒高频超声能清晰地显示肠系膜淋巴结,对临床诊断肠系膜淋巴结炎和治疗具有重要的应用价值。     

CONGENITAL CHOLEDOCHAL CYST——REPORT OF 56 CASES

Objective. The aim of this paper is to describe the mechanism, clinical manifestation, diagnosis and surgical management of congenital choledochal cyst. Methods. From 1984 to 1997, 56 cases of congenital choledochal cyst were reviewed. Among them, 8 patients were male, 48 patients were female, the age ranges from 12 to 50 years old with an average of 26.3. Results. The main clinical manifestation includes jaundice, abdominal pain and abdominal mass. All of them were confirmed by ultrasonography, while 39 cases were performed ERCP and PTC with the same diagnosis. Fifty-one patients were performed cystectomy and hepatojejunostomy, two cases were per-formed cystjejunostomy because of diffused angioma and severe hemorrhage respectively, external drainage was performed in one case with emergent cholangitis, the other two cases were reported malignancy through biopsy and operation was abandoned. Conclusions. Ultrasound diagnostics is essential to accurately diagnose the cyst, preoperative ERCP is helpful for differentiating pancreatic duct from bile duct, while MRCP is a reliable method ; cystectomy and cholangiojejunostomy is recommended, laparoscopic procedure is becoming more and more accepted.     

脐尿管囊肿伴感染的CT影像学分析

目的探讨脐尿管囊肿伴感染的CT表现。方法回顾性分析8例经手术证实为脐尿管囊肿伴感染病例的CT表现,包括病变部位、大小形态、内部结构及增强后改变、临近组织结构的变化等。结果轴位像及矢状位成像显示8例脐尿管囊肿伴感染病变均为膀胱与脐之间囊性肿物,囊壁较厚,其内囊液密度略高于水;1例肿物边界较清晰,7例表现为边缘毛糙,周围脂肪间隙模糊,其中4例肿物前缘与前腹壁粘连紧密,Retzius间隙浑浊。增强扫描后7例表现为囊壁中等或明显强化,仅1例囊壁呈轻度强化。结论脐尿管囊肿伴感染有其独特的发生部位,CT表现典型,结合临床症状不难做出准确诊断。     

Sonographic appearances of mesenteric cysts--report of 2 cases]

Mesenteric cyst is defined as a cystic mass located in the mesentery, and has rarely been reported. Before the clinical use of ultrasound (US), the imaging diagnosis of the abdominal mass depended on plain X-ray films and contrast examinations to delineate the space occupying lesion. The later use of US enables us to readily identify mass character. For example, whether it is cystic or solid, with or without septum, or whether there is sediment in the cyst. US examination is the method of choice in evaluating abdominal masses. Two cases of pediatric mesenteric cysts were brought to our hospital on account of complication. US of the first patient revealed a huge cystic mass with sediment and septae in central abdomen. Mild hydronephrotic change of the right kidney was found. The pathology showed nonepithelial lining multiloculated cyst surrounded by a thick, fibrotic granulomatous wall with suppurative cell infiltration and some calcifications. The histopathological diagnosis was an infected pseudocyst. The other patient had a cyst which twisted the jejunum and resulted in intestinal obstruction. US found dilated intestinal loops and a septate cystic mass in epigastrium. The pathology showed a multiloculated cyst with mesothelial lining, representing a mesothelial cyst. Both patients were treated surgically and had an uneventful recovery. In this article we described and explained the findings on US, discussed the differential diagnoses and compared different imaging modalities.     

肝下巨大卵巢成熟性囊性畸胎瘤并发对侧卵巢子宫内膜异位囊肿1例报告及文献复习

目的：探讨肝下巨大卵巢成熟性囊性畸胎瘤并发对侧卵巢子宫内膜异位囊肿患者的临床特点,分析诊断经验和治疗过程。方法：回顾性分析1例肝下巨大卵巢成熟性囊性畸胎瘤并发对侧卵巢子宫内膜异位囊肿患者的临床资料,并进行相关文献复习。结果：患者体检时发现腹腔巨大肿物。妇科超声提示腹部巨大囊肿,左卵巢内见61mm×48mm囊性光团回声,内液稠。腹部CT平扫提示右腹部巨大团块状混杂密度影,其内可见脂肪密度、钙化密度及软组织密度影,临近肝脏呈受压状态改变。术中探查,右侧卵巢肿瘤大小约40cm×35cm×30cm,上达膈下,下至盆腔,肿瘤后壁与肝左叶粘连,并将肝脏挤向右上方。左侧卵巢子宫内膜异位囊肿大小约7cm×6cm×6cm。手术剥除右侧卵巢肿瘤及左侧卵巢子宫内膜异位囊肿并重建双侧卵巢。病理诊断,右侧卵巢成熟性囊性畸胎瘤、左侧卵巢子宫内膜异位囊肿。术后随访已超过2年,未发现肿瘤复发,并经体外受精-冻融胚胎移植（IVF-ET）受孕。结论：巨大卵巢成熟性畸胎瘤粘连于肝脏下方同时并发对侧卵巢子宫内膜异位囊肿临床上罕见,手术治疗预后良好,如术后不孕,应及早行IVF-ET助孕。     

成人胆总管囊肿的诊断与治疗

本文通过20例成人胆总管囊肿临床资料的分析,提出了本病的特点、诊断依据和治疗方法。强调该病的唯一疗法是施行外科手术。囊肿空肠吻合术和囊肿切除术适于成人病例。     

肠系膜静脉血栓形成8例诊治

目的 探讨肠系膜静脉血栓形成的诊断和治疗。方法 回顾性分析8例肠系膜上静脉血栓形成患的临床资料。结果 8例中4例为腹部手术后患,4例为不明原因起病。临床主要表现为腹痛、腹胀,初期症状重但体征轻。术前确诊2例。所有患均经手术和病理证实,全部经手术治愈,2例术后出现短肠综合征。结论 肠系膜静脉血栓形成术前确诊困难。CT、彩色多普勒超声检查是诊断本病较为敏感的方法。早期手术切除受累肠管及系膜、门静脉主干出现血栓时行门静脉取栓及恰当的抗凝治疗是本病治疗的关键。