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患者女性,24岁。右上腹无痛性包块进行性增大两年。近半年有心悸、头晕、一过性视物不清,双下肢及眼睑浮肿,尿量明显增多,夜间尤甚。体检:一般状态好,血压24/14kpa,眼睑浮肿。心界向左扩大。右上腹触及20×15cm包块,质中,可活动,边界清。腹部无移动性浊音。双下肢轻度浮肿。实验室检查:尿糖(+),血糖18.50mmol/L,血沉38mm/h。心电图及胸片示高血压性心脏病改变。腹部CT及B超示左中腹包块。剖腹探查发现,肿块位于结肠脾曲及降结肠系膜后、左肾门前内侧,呈葫芦形,约22×12cm大小,与大网膜及左侧腹膜致密粘连,质中。锐性分离粘连,见表面呈结节状,包膜完整,血管丰富,粗血管直径达1cm。完整切除肿块,周围未见肿大淋
Female patient, 24 years old. The painless mass in the right upper quadrant increased progressively for two years. In the past six months, there was heart palpitations, dizziness, transient visual obscureness, edema of both lower extremities and eyelids, and increased urine output, especially at night. Physical examination: general condition is good, blood pressure 24/14kpa, eyelid edema. The heart has expanded to the left. The right upper abdomen touched a 20×15 cm mass, which was active and clear. The abdomen has no moving dullness. Both lower limbs are slightly swollen. Laboratory tests: urine glucose (+), blood glucose 18.50mmol/L, ESR 38mm/h. Electrocardiograms and chest radiographs indicate changes in hypertensive heart disease. Abdominal CT and B-ultrasound showed left middle abdominal mass. The exploratory laparotomy found that the masses were located in the colon of the spleen and descending mesorectum and left the anterior medial portion of the kidney. The lump was gourd-shaped and was about 22×12 cm in size. It was densely adherent to the greater omentum and the left peritoneum. Sharp separation of adhesions, see the surface was nodular, complete envelope, blood vessels, thick blood vessels up to 1cm in diameter. Complete removal of the mass, no swelling around the shower