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患者,男,46岁,因腹胀、腹痛、周期性稀水样便1年余,加重15天伴手足抽搐3天入院。查体:T36.6℃ P82次/分 R20次/分 BP13.3/10.7kPa。心肺未见异常,腹平坦,未见胃型及肠型,左上腹饱满,有压痛,无反跳痛,无腹肌紧张,未触及包块。化验:WBC 11.0×10~9/L,N 0.84,K~+2.6μmol/L,Ca~+2.1μmol/L,Cl~-100μmol/L,Mg 0.67μmol/L,CO_2-CP18μmol/L,血糖6.1μmol/L。上消化道钡餐造影提示:胃扭转,收入院。 临床上以慢性胃扭转行剖腹探查术。术中发现:胰体尾部有一15cm×15cm×15cm大小肿块,呈乳突状,质硬,色灰白,包膜完整,与周围组织无粘
The patient, male, 46 years old, was hospitalized for 3 days due to abdominal distension, abdominal pain, and periodic dilute water samples for more than one year and aggravation of 15 days with hand-foot convulsions. Physical examination: T36.6°C P82 beats/min R20 beats/min BP13.3/10.7kPa. Cardiopulmonary no abnormalities, flat abdomen, no stomach and bowel type, full left abdomen, tenderness, no rebound tenderness, no abdominal muscle tension, masses are not touched. Laboratory tests: WBC 11.0×10~9/L, N 0.84, K~+2.6 μmol/L, Ca~+2.1 μmol/L, Cl~-100 μmol/L, Mg 0.67 μmol/L, CO_2-CP 18 μmol/L, blood glucose 6.1 μmol/L. Upper gastrointestinal barium meal angiogram prompt: Gastric torsion, income hospital. Clinically, chronic gastrectomy was performed by laparotomy. Intraoperative findings: There is a 15cm × 15cm × 15cm lump in the tail of the pancreas. It is papillary, hard, grayish in color, and completely covered with no adhesion to the surrounding tissue.