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患者:男,22岁。腹泻,有时脓血便1年,在外地以“痢疾”、“痔”治疗无效来我院就诊。无多发性结肠息肉家族史。体检:轻度贫血貌,心、肺、肝、肾未见异常。直肠镜检:距肛缘4cm处息肉样肿块,占据整个肠腔1周;病理报告:直肠腺癌。术中见:左半结肠多发性肿块;盲肠肿块为3×2×2cm盲肠周围淋巴结肿大。作全结肠切除回肠造瘘术。术后取左半结肠解剖见鸽蛋至黄豆大的肿块多达21个。病理报告:(1) 直肠腺癌(高分化);(2) 直肠周围淋巴结转移性腺癌;(3) 结肠腺瘤;(4)
Patient: Male, 22 years old. Diarrhea, sometimes with sepsis and bloody stools for 1 year, has been treated in our hospital with “dysentery” and “deafness” ineffective. No family history of multiple colon polyps. Physical examination: Mild anaemia appearance, no abnormalities in heart, lung, liver and kidney. Rectal microscopy: polypoid mass 4cm away from the anal margin, occupying the entire intestine for 1 week; pathology report: rectal adenocarcinoma. See intraoperatively: multiple masses of the left colon; cecal masses were 3 x 2 x 2 cm peri-cecal lymph nodes. For total colectomy ileostomy. After the surgery, the left colon was dissected to see as many as 21 large lumps of pigeon eggs and soybeans. Pathology reports: (1) rectal adenocarcinoma (highly differentiated); (2) metastatic adenocarcinoma of the perirutal lymph nodes; (3) colonic adenoma; (4)