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1 病例 病人,女,46岁。因进食梗噎感2个月,经食管镜检查,诊断为食管下段鳞癌。病人43年前患脊髓灰质炎,遗留后遗症,右下肢较左侧短约10cm,脊柱侧弯畸形,骨盆发育小变形,右足外翻,用双拐辅助行走。 1998年3月行食管下段癌切除,食管胃主动脉弓上吻合术。术中见由于骨盆畸形发育,腹压较高,修复膈肌时张力适度。膈肌发育无异常。术后恢复顺利,术后20日出院。术后40日活动后觉腹痛,进食后腹胀,偶伴呕吐,活动后胸闷。查胸片证实为膈疝,1998年5月12月再次开胸,术中见于原膈肌切口前外方有一约8cm长裂口,边缘不规整,距原膈肌切口1.5cm,原膈肌切口缝线完好。部分空肠大网膜横结肠疝
1 Case Patient, female, 46 years old. Due to eating stench for 2 months, esophageal examination revealed a diagnosis of squamous cell carcinoma of the lower esophagus. The patient suffered from poliomyelitis 43 years ago and left with sequelae. The right lower extremity is about 10cm shorter than the left side, scoliosis deformity, small deformed pelvis, right valgus, and crutches. In March 1998, the esophageal cancer was removed and the esophagogastric aortic arch anastomosis was performed. During the operation, due to the development of pelvic deformity, the abdominal pressure was high, and the tension was moderate when the diaphragm was repaired. There is no abnormality in diaphragm development. Postoperative recovery was smooth and the hospital was discharged 20 days after surgery. After 40 days of activity, abdominal pain was felt, abdominal distension after eating, occasional vomiting, chest tightness after the activity. Chest radiographs were confirmed as convulsions. The chest was opened again in May of May 1998. During the operation, there was an approximately 8 cm long gap in the front of the original diaphragmatic incision. The margin was irregular and 1.5 cm away from the original diaphragmatic incision. The original diaphragmatic incision suture was intact. Part of the jejunum