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患者,女,36岁.因左上腹反复隐痛10年,诊断“胃平滑肌瘤”1年,要求手术治疗,于1995年1月10日入院.腹痛位于左上腹部,持续性隐痛,时轻时重,无反酸、嗳气,无呕血、便血,曾疑为“胃炎”以西米替丁等药物治疗不见好转.1993年12月20日胃镜检查:见胃体前壁近胃角5cm处有一约1×1cm大小粘膜呈半球状隆起,表面光滑.活检病理报告为正常胃粘膜组织.诊断为胃平滑肌瘤.为进一步确诊到省级医院进行超声内镜检查,见胃体前壁有0.8×0.6cm隆起,表面光滑,色正常.超声见肌层浆膜侧有0.74×0.54 cm低回声区,边界清,内无血流,诊断胃平滑肌瘤.查体:左上腹肋缘下饱满,触痛明显.1995年1月14日行胃平滑肌瘤切除术.术中见胃壁柔软光滑,未扪及包块,与术前诊断不符.进一步检查发现左侧腹壁正中线与左锁骨中线
Patient, female, 36 years old. Sustained pain in the left upper quadrant for 10 years, diagnosis of “stomach leiomyoma” for 1 year, requiring surgical treatment, admitted to hospital on January 10, 1995. Abdominal pain in the left upper abdomen, persistent pain, when light Weight, no acid reflux, hernia, no vomiting blood, blood in the stool, was suspected as “gasitis” with cimetidine and other drug treatment did not improve. December 20, 1993 endoscopy: see the anterior wall of the stomach 5cm near the stomach has a 1×1cm mucous membrane hemispherical uplift, smooth surface. Biopsy pathology report was normal gastric mucosa. Diagnosis was gastric leiomyoma. To further confirm the diagnosis of endoscopic ultrasonography at the provincial hospital, see the anterior body of the stomach body 0.8 × 0.6cm uplift, smooth surface, normal color. Ultrasonography see muscle layer side of the serosal 0.74 × 0.54 cm low echo area, border clear, no blood flow, diagnosis of gastric leiomyoma. Examination: left upper abdomen under the costal margin, The tenderness was obvious. On January 14, 1995, the gastric leiomyoma was removed. During the operation, the stomach wall was soft and smooth, without palpable mass, which was inconsistent with the preoperative diagnosis. Further examination revealed that the median line of the left abdominal wall and the left midclavicular line