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患者女,24岁。因右中上腹包块一年。偶有剑突下不适及阵发性疼痛,于1988年1月3日,入院。体检:T36.1℃,P80次/分,Bp17/10kPa(130/80mmHg)一般状态尚好,巩膜、皮肤无黄染。中上腹脐右侧可触及一鸡卵大球形包块,硬度中等,表面光滑,压痛(-),界限清楚,可移动,肝胆未触及,全腹柔软。B型超声示:脐水平稍偏右侧见一4.6×3.0cm大小包块,边界清楚,包膜完整的低回声,其内可见小的液性无回声暗区。腹部CT示:腹后壁于腔静脉和腹主动脉之间的前方有一3.2×3.7cm圆形肿物,中间有坏死区。在连续硬膜外麻醉下行右腹直肌跨脐切口探查,显露腹膜后肿物约5×5×4cm,质地较硬,表面光滑,可移动。肿物位于腔静脉和腹主动脉之间,压迫腔静脉及腹主动脉。术中探查触摸肿物时患者出现大汗,心悸,烦躁不安,
Female patient, 24 years old. Due to right middle and upper abdominal mass for one year. Idiopathic discomfort and paroxysmal pain were occasionally admitted to hospital on January 3, 1988. Physical examination: T36.1°C, P80 beats/min, Bp17/10kPa (130/80mmHg) The general condition is still good, and the sclera and skin are yellow-stained. On the right side of the upper abdomen of the abdomen, a large spherical mass of chicken eggs can be touched, which is of medium hardness, smooth surface, tenderness (-), clear boundary, movable, untouched liver and gallbladder, and soft whole abdomen. B-ultrasound showed: The umbilical level slightly to the right see a 4.6 × 3.0cm mass, the boundary is clear, a complete low echo capsule, which can be seen within the small liquid echo-free dark area. Abdominal CT showed a 3.2 × 3.7 cm round mass in front of the ventral wall between the vena cava and the abdominal aorta with a necrotic area in between. After continuous epidural anesthesia, the right rectus abdominis muscle was explored across the umbilical incision, revealing a retroperitoneal mass of approximately 5x5x4 cm, with a hard texture, a smooth surface, and mobility. The tumor is located between the vena cava and the abdominal aorta, compressing the vena cava and the abdominal aorta. During the intraoperative exploration of the touched mass, the patient experienced sweating, palpitations, and irritability.