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患者,女,15岁。因上腹部胀痛不适伴纳差1年,加重伴呕吐1月入院。1年前患者感上腹部疼痛、饱胀不适伴食欲下降,曾在当地医院诊治无好转,近1月来,上述症状加重伴恶心、呕吐及乏力,无厌油。体检:贫血貌,发育一般,营养差,毛发稀疏。心肺检查正常,腹软,上腹部可扪及一5×4cm光滑、可移动的包块,无压痛。血常规:Hb 90g/L,WBC 8.4×10~9/L。胃镜示贲门下3cm始沿胃前壁到十二指肠球部均可见毛发和食物混合成的团块,几乎占据整个胃腔,外观呈胎头状。追问病史,患者有嗜食毛发史。诊断毛发性结石。手术发现由胃底至十二指肠球部充满毛发和食物等混合成的巨大结石,沿胃前壁上段纵形切开,将其完整取出。病理标本重450g,以毛发为主混有食物残渣。
Patient, female, 15 years old. Due to abdominal pain discomfort with anorexia 1 year, aggravated with vomiting January admission. A year ago, the patient felt abdominal pain, discomfort with loss of appetite, had no improvement in the local hospital diagnosis and treatment, the past month, the above symptoms aggravated with nausea, vomiting and fatigue, no greasy oil. Physical examination: anemia appearance, general development, poor nutrition, hair thinning. Cardiopulmonary examination was normal, abdominal soft, palpable on the abdomen and a 5 × 4cm smooth, removable mass, no tenderness. Blood: Hb 90g / L, WBC 8.4 × 10 ~ 9 / L. Gastroscopy showed cardia 3cm at the beginning along the anterior wall of the stomach to the duodenal bulb were visible hair and food mixed into the mass, almost occupy the entire gastric cavity, the appearance of fetal head showed. Asked history, patients have a history of eating hair. Diagnosis of hair stones. Surgical findings from the fundus to the duodenal bulb filled with hair and food mixed into a huge stone, along the longitudinal section of the anterior wall of the stomach incision, its complete removal. Pathological specimens weighing 450g, with hair-based mixed with food residue.