腹膜后支气管源性囊肿一例

患者男,55岁.上腹部腹胀伴隐痛半年,拟诊为腹部肿块于2010年9月17 日入院.入院查体:上腹部饱满,肝脾未及,腹部肿块未触及.实验室检查:血肿瘤标志物7248 U/ml.B超检查示中上腹囊性包块,约4 cm大小.上腹部CT示:肝胃间隙内有一个囊性肿物,考虑腹膜后间隙神经原性肿瘤可能,增强扫描时血供增强不明显(图1A,1B).     

苗勒管源性巨大囊肿1例

患者男性,16岁。因下腹部迅速增大包块10余天,感腹胀、呕吐入院。入院查:腹部高度膨隆,腹壁浅静脉怒张,剑突下耻骨联合上可触及一巨大包块。包块质中度,边界清,表面光滑,活动性差,无压痛,呈囊性,震水感强。B超提示:剑突下至耻骨联合,双侧腰部为一巨大囊性包块约12cm×20cm大小。血红蛋白95g/     

肝平滑肌肉瘤的诊断与治疗

平滑肌肉瘤是肝脏罕见的恶性肿瘤 ,其临床表现、影像学特征、病理诊断及预后等方面具有一定的特殊性 ,探讨其诊治具有一定的临床价值 ,我院曾收治 3例肝平滑肌肉瘤 ,现报告讨论如下。1　临床资料病例 1.男 ,4 4岁 ,因反复上腹部酸痛半年 ,上腹部包块伴腹胀 2个月 ,剑突下扪及 10 cm× 10 cm肿块 ,质软 ,乙肝丙肝 ,AFP和 CEA均阴性 ,α-岩藻糖酐酶(AFU) 42 0 μg/L,肝功能 child A级 ,B超探及肝左右叶内多个囊实质性混合性包块 ,CT示肝左外叶巨大囊实质性包块 ,大小约 16 cm× 15cm,肝 、 、 段有多个低密度占位 ,最大 8cm× 6 cm。行…     

囊性血管平滑肌脂肪瘤一例

<正>病例患者,女,51岁,腹胀伴消瘦两个月入院。体检无明显异常,无结节性硬化病史。肝功能正常。HBs Ag(+),HBe Ab(+),HBc Ab(+),Anti-HCV(-)。腹部B超提示:肝右叶可见一囊实性包块,大小约8 cm×10 cm;增强CT扫描提示:肝右叶可见一囊实性肿块,囊性部分大小约8.4 cm×6.0 cm×4.9 cm,增强扫描未见强化,实性部分边界欠清晰,大     

腹膜后副神经节瘤3例报道

病例1女,31岁,因发现腹部包块7个月入院,无疼痛、发热、恶心、呕吐等。B超发现右中上腹脊柱右侧前方有一14cm×10.5cm大囊实性包块,内有弱回声点,包膜完整。CT检查示右侧腹腔内有一囊实性低密度肿块,10cm×10cm大,囊性区CT值为20Hu,实性区为44Hu。术中见右上腹腹膜后、十二指肠     

重复胃原发性腺癌一例

患者男性,25岁.因"B超检查发现左上腹囊性占位7d"于2011年1月2日入院.患者7d前体检腹部B超探及胃大弯旁有一约90 mm类圆形囊性包块.上腹部CT示:左上腹脾胃间有一截面为8.9 cm×8.8 cm囊性占位性病变,病变内侧壁与胃体大弯侧无分界,外侧壁局限性增厚,增强扫描后病变囊壁强化,见图1a.查体:一般状况良好,浅表淋巴结无肿大,腹平软,左上腹可触及囊性包块,边界清,全腹无压痛,肠鸣音正常.入院后查血CEA、CA199正常.     

附件恶性肿瘤合并结肠恶性肿瘤一例

患者 ,女 ,5 3岁 ,腹痛腹胀 4个月 ,加重伴消瘦 10d。查体 :慢性病容 ,消瘦 ,轻 (中度 )贫血 ,心肺阴性 ,腹部膨隆 ,以中下腹为主 ,右上腹扪及一约 10 .0cm×7cm大小硬质包块 ,边界清楚 ,表面不光滑 ,轻度活动 ,无压痛 ,中下腹平脐上三横指 ,扪及一巨大囊性包块 ,无活动 ,无压痛 ,移浊 ( +)。B超提示 :右上腹一9.5cm× 7.0cm大小实质性包块 ,右上腹见一 15 .0cm× 10 .0cm大小混合性包块 ,中下腹见一 3 0 .0cm× 2 5 .0cm大小囊性包块。经积极术前准备 ,以腹腔包块行剖腹探查术。术中见 :左侧卵巢见 3 0 .0cm× 2 8.0cm× 2 8.0cm巨大囊性…     

橡胶管腹腔引流致肠管穿孔2例

病例报告 例1女36岁.因下腹部包块伴小腹坠胀不适,大便不畅半年余入院.B超检查提示盆腔23 cm×18 cm大包块,边界清,内部回声不均,以"腹部包块"入院.     

腹膜假性粘液瘤1例报告

患者男,55岁,入院前3个月发现右下腹包块,初为核桃大小。无发热,感乏力并体重减轻。查体:右下腹触及12×10cm包块,边界不清、表面光滑可推动,触之有囊性感。无明显压痛。结肠气钡双重造影未见明显病变,阑尾部分充盈。CT检查示下腹不规则囊性包块,肠道受压移位。B超提示下腹巨大肿块,其中大量液性暗区及散在相对回声光点,CT及B超诊断均考虑腹腔粘液瘤。腹部包块诊断性穿刺抽出少许粘稠胶样物。剖腹探查见腹腔大量淡黄色胶样物,约2500ml、阑尾头体部见一5×3×3cm不规则包块,囊壁已破,呈灰     

胰腺实性假乳头状瘤1例

患者,女,30岁,因餐后中上腹部隐痛不适1年,发现上腹部包块半月就诊。查体:中上腹部可及φ6 cm左右包块,边界欠清,光滑,轻压痛,难推动,未及血管杂音。B 超示中上腹混合性团块。CT示胰头区肿块。AFP,CEA, CA19-9结果正常。手术所见:后腹膜胰头下方,下腔静脉内侧约6 cm×7 cm球形肿块,包膜完整,周围无肿大淋巴     

Clinical outcomes in patients with renal artery stenosis treated with stent placement with embolic protection compared with those treated with stent alone

Purpose: To compare the clinical outcomes in patients with chronic renal insufficiency (CRI) and renal artery stenosis (RAS) following renal artery (RA) stent placement with and without embolic protection device (EPD) usage. Materials and Methods: Eighteen patients who had RA stent placement with EPD were matched to control patients (RA stent only). Blood pressure, number of hypertensive medications, and estimated glomerular filtration rate (eGFR) at 3 months before the procedure and after 12 months were determined. An increase of ≥ 20% in eGFR at 12 months from baseline was defined as "improvement," decrease of ≥20% as "deterioration," and an eGFR change between those values as "stabilization" at 12 months. Results: At 12 months, stage 4 patients treated with EPD had significantly higher eGFR than controls (P = .01). There was no statistical difference in blood pressure outcomes between the 2 groups. Conclusions: Patients with stage 4 CRI did significantly better with EPD than those treated without it.     

Intubation with propofol augmented with intravenous lignocaine

Sixty patients of ASA grade 1 and aged 18 to 55 years were admitted to a double-blind study. Anaesthesia was induced with propofol 2.5 mg/kg after intravenous pretreatment with lignocaine 1.5 mg/kg or a similar volume of isotonic saline. The quality of subsequent tracheal intubation was graded and the pressor response to tracheal intubation assessed. There were no significant differences between treatment groups.     

510例腹腔镜联合纤维胆道镜胆总管切开取石术的临床应用

目的探讨腹腔镜联合纤维胆道镜治疗胆总管结石的可行性及临床应用价值。方法1998年～2007年对510例患者行腹腔镜胆总管切开取石(laparoscopic common duct exploration,LCDE),与同期300例开腹(opensurgery,OS)手术者比较。术前确诊者,术中直接行胆总管切开胆道镜取石;术前有黄疸史、胰腺炎史和(或)直接胆红素增高、胆系酶(AKP、GGT)增高者,或胆总管在0.8cm以上者行术中造影,明确有胆总管结石的切开胆总管胆道镜取石。405例置T管引流(留置T管组),105例行胆总管Ⅰ期缝合(I期缝合组)。结果手术均获成功,与OS组比较,手术时间、术中出血量、术后并发症发生率(胆瘘、出血)差异无统计学意义;住院日、术后镇痛药使用次数、腹腔或切口感染率、残石率明显减少。无中转开腹。30例T管引流口靠近肋弓而引起术后疼痛,2例术后2dT管才引流出胆汁。留置T管组有24例胆总管残余结石,3月后经胆道镜取石成功。留置T管组手术时间平均(110±15)min,平均术后住院8d;Ⅰ期缝合组手术时间(95±8)min,平均术后住院5d。结论LCDE是治疗胆总管结石安全、有效的方法,同样可起到创伤小、痛苦轻、恢复快、住院时间缩短等微创效果,如能在取净结石的情况下行胆总管Ⅰ期缝合,微创效果尤为明显。