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1 病情摘要 患者,男性,6岁,“发现右腹股沟逐渐增大肿物四个月”来就诊入院。述四月前无意中发现右腹股沟肿物约鸽卵大小,无不适感。肿物逐渐增大,近日增大明显,约核桃大小。平卧无消失,无盗汗,无发热,无疼痛,食欲及睡眠均佳。入院后查体:右腹股沟内下方见约30mm×30mm×20mm大小肿物凸出体表。触之质韧,无触痛,无浅表静脉怒张,皮温不高,基底固定,透光试验阴性。阴囊无肿大,睾丸触之清,双侧等大。辅查:血常规:WBC 10.0×10~9个/L,N 70.3％,L29.4％,Hb 141g/L。胸片及骨盆片未见异常。B超,右腹股沟部有一约30mm×30mm×20mm包块,包膜完整,内有不规则回声的实质性肿物;肝、胆、脾、胰、双肾无异常,即在氯胺酮麻醉下手术治疗。术中取右斜疝切口,切开腹外斜肌腱膜即可见到实质性肿物二个,一个约25mm×25mm×25mm,一个约8mm×8mm×8mm,其囊壁质韧,呈灰白色与腹外斜肌、腹横肌粘连。肿物完整切除后,见精索完整,髂腹下,髂腹股沟神经无损伤,睾丸及附睾正常。术后患者切口甲级愈合。
A summary of patients with disease, male, 6 years old, “found the right groin gradually increased mass four months” to hospital for treatment. Four months ago, inadvertently found about the right groin tumor about the size of a dove, no discomfort. Mass gradually increased recently increased significantly, about the size of walnuts. Supine no disappearance, no night sweats, no fever, no pain, good appetite and sleep. After admission, physical examination: see below the right groin about 30mm × 30mm × 20mm size of the tumor protruding body surface. Touch of tough, no tenderness, no superficial venous rage, skin temperature is not high, the base is fixed, the light transmission test negative. No swelling of the scrotum, testicles touch the clear, bilateral and other large. Auxiliary examination: blood: WBC 10.0 × 10 ~ 9 / L, N 70.3%, L29.4%, Hb 141g / L. No abnormal chest and pelvic films. B ultrasound, the right groin has a 30mm × 30mm × 20mm mass, complete capsule, there are irregular echoes of substantial tumor; liver, gallbladder, spleen, pancreas, kidneys without exception, that is under anesthesia in ketamine surgery treatment. Surgery to take the right oblique hernia incision, incision of abdominal oblique aponeurosis can see two substantive tumor, a about 25mm × 25mm × 25mm, a about 8mm × 8mm × 8mm, the cystic wall of tough, pale gray and Abdominal obliques, abdominal transverse muscle adhesions. Complete removal of the tumor, see the spermatic cord complete, ilio-abdominal, iliovaginal nerve injury, testicular and epididymis normal. Postoperative patients incision grade healed.