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我院外科收治196例胃肠肿瘤中有3例空肠肿瘤病人,现将诊治情况.报告如下:1 病例介绍例1:男,46岁.因反复上腹部隐胀痛伴黑便2年,胃镜检查,发现十二指肠球部有1cm×1cm癜痕,粘膜糜烂,少量出血点,诊断十二指肠球部溃疡.经内科治疗1年,症状不缓解.复查胃镜仍发现十二指肠球部均1cm×1cm瘢痕,粘膜充血,仍诊断为十二指肠球部溃疡,转外科手术治疗.手术中发现十二指肠球部前壁瘢痕约2cm×2cm大小.行胃肠吻合时发现空肠距屈氏韧带约28cm处肠系膜缘上有一个4cm×2cm×1cm肿瘤,肠腔外生长,基底部质地较硬.表面光滑.无出血.手术切除肿瘤及部分空肠,术后解剖标本见十二指肠球部瘢痕约2cm×2cm质硬,粘膜皱折消失,有出血点.肿瘤基底部向肠腔内突出约1cm×1.5cm,肠粘膜结构破坏,粘膜糜烂出血.病理检查,诊断空肠类癌,十二指肠球部溃疡.术后随访9年,健康.
In our hospital, there were 3 cases of jejunal tumours in 196 cases of gastrointestinal cancer. The diagnosis and treatment status is as follows. 1 Case introduction example 1: Male, 46 years old. Due to repeated upper abdominal discomfort pain with black stool for 2 years, endoscopy Examination revealed that the duodenal bulb had 1cm x 1cm scar, mucosal erosion, a small amount of bleeding, diagnosis of duodenal ulcer. After 1 year of medical treatment, symptoms did not relieve. Review of the gastroscope still found duodenum The balls were all 1cm x 1cm scars, mucosal congestion, still diagnosed as duodenal ulcers, surgical treatment. The anterior wall scar of the duodenal bulb was found to be about 2cm x 2cm in size during operation. It was found that there was a 4cm × 2cm × 1cm tumor at the mesenteric margin about 28cm from the jejunal flexor ligament. The growth was extraintestinal, the basement was hard, the surface was smooth, there was no bleeding, and the tumor and some jejunum were removed by surgery. The duodenal scar was about 2cm x 2cm in stiffness, mucosal folds disappeared, and there was a bleeding point. The base of the tumor protruded approximately 1cm × 1.5cm from the lumen of the intestine, the structure of the intestinal mucosa was destroyed, and the mucous membrane was eroded and bleeding. Pathological examination, diagnosis Jejunoid carcinoid, duodenal bulb ulcer. Postoperative follow-up of 9 years, health.