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例1 男,56岁。两月前出现右上腹痛,可在右下腹触及鸡蛋大小肿块,曾以“阑尾周围脓肿”抗炎治疗症状有好转,但肿块大小无明显改变。入院查体右下腹有8cm大小肿块,质硬,轻压痛,活动欠佳。纤维结肠镜示结肠脾区有肿块,肠腔狭窄,未能向其近端结肠再进镜。钡剂灌肠发现横结肠脾区有5cm长不规则狭窄段,管壁僵硬,粘膜破坏中断,盲肠充盈欠佳。术中见盲肠外后方有直径约10cm肿块,前壁浆肌层受侵,回结肠系膜中部有肿大的淋巴结,横结肠脾区有一4cm疤痕样肿块,侵及模结肠条膜,行右半结肠和横结肠根治性切除。术后病理检查盲肠肿物为高分化腺癌,横结肠肿物为印戒细胞癌。随访
Example 1 Male, 56 years old. Two months before the upper right abdomen pain, can touch the size of the egg in the right lower abdominal mass, once the “appendiceal abscess” anti-inflammatory treatment symptoms have improved, but the size of the mass did not change significantly. Admission examination on the right lower abdomen was 8cm in size, hard mass, light tenderness, and poor activity. Colonoscopy showed a mass in the spleen area of the colon and a narrow lumen, which failed to enter the proximal colon. In the barium enema, a 5 cm long, irregular, narrow segment of the transverse colonic spleen region was found. The wall of the tube was stiff, and the destruction of the mucosa was disrupted. The cecum filling was poor. See the surgery outside the cecum with a diameter of about 10cm behind the tumor, the front wall muscle layer invasion, the middle of the mesentery with enlarged lymph nodes, the transverse colon has a 4cm scar in the spleen area, invade the colon membrane, the right colon And radical colonectomy. Postoperative pathological examination of cecal tumors was well-differentiated adenocarcinoma, and transverse colon tumor was signet ring cell carcinoma. Follow-up