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患者男,5岁.其母代诉自幼腹部胀满,二便正常.曾在外院检查腹部X平片未明确诊断.近半年腹部逐渐增大,腹部隐痛,伴阵发性绞痛、偶有恶心、呕吐.大便秘结,每2～3天1次,腹部可见肠蠕动波,经禁食及止痛药物治疗症状可缓解.1个月来腹胀不见缓解,腹痛呈阵发性加剧,进食后症状加重、呕吐物为胃肠内容物,无胆汁,无臭味,近2～3天排气、排便停止.经胃肠减压、输液等对症治疗无效.体检:体重24kg,体温36.8℃,脉搏108次/分,呼吸24次/分,血压17/12kPa.慢性病容,面色苍白、皮肤弹力差.心肺无异常.腹部高度膨隆.扪及一巨大肿物约50cm×8cm,质韧,表面光滑.呈马蹄状占据左侧腹腔.肿物上自左肋缘下达盆腔.并向右下腹伸延,其右上缘距右肋缘下约5cm,右腹中部空虚感,可见肠蠕动波.肝脾未触及.全腹均有轻压痛.无肌紧张及反跳痛,移动性浊音(一),肠蠕动音活跃,未闻高调及气过水音.其余无异常.
Patient male, 5 years old. His mother sued abdominal bloating since childhood, two will be normal. Have examined the abdomen X-ray was not diagnosed. Nearly half of the abdomen gradually increased, abdominal pain, with paroxysmal angina, even Nausea, vomiting.Constipation, every 2 to 3 days 1, abdominal visible peristalsis waves, fasting and analgesic drugs can relieve symptoms .1 months to see no bloating, abdominal pain was paroxysmal increase, eating After the symptoms aggravate, vomit is gastrointestinal contents, no bile, no odor, nearly 2 ~ 3 days exhaust, defecation stopped by gastrointestinal decompression, infusion and other symptomatic treatment is invalid.Physiological examination: weight 24kg, body temperature 36.8 ℃ , Pulse 108 beats / min, breathing 24 times / min, blood pressure 17 / 12kPa. Chronic disease, pale, skin elasticity is poor. Cardiopulmonary no abnormalities. Abdominal height bulging. Palpable a huge tumor of about 50cm × 8cm, The surface is smooth .Horseshoe-like occupy the left abdominal cavity.Plasty from the left costal edge pelvic cavity and extended to the right lower quadrant, the right upper edge of the right costal margin about 5cm, right middle abdomen empty sense, we can see peristalsis wave. No touch of the spleen. All abdomen are mild tenderness. No muscle tension and rebound tenderness, mobility dullness (a), active bowel movement, unheard-of high-profile and gas over the water sound The rest without exception.