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我们近2年收治以上消化道大出血为首发症状的原发性脾恶性肿瘤2例。现报告如下。例1.男,63岁。因反复恶心、黑便3年,呕鲜血5天入院。入院后经输血、止血等治疗4小时后,又呕鲜血约400ml,解黑便1次,量约150g,血压7/5kPa;急诊胃镜示:胃底静脉曲张,胃底结节状肿物。行剖腹探查发现:脾脏增大,可见10cm×10cm和4cm×6cm,分别与胰体、尾,胃底、体浸润融合,两个肿瘤均质硬,凹凸不平。胃底、体静脉曲张迂回,行脾切除,胰体、尾部分切除,胃近端部分切除术。病理报告:脾脏类癌并胰、胃转移。术后无继续出血,予输液、抗感染、化疗等治疗,住院20天痊愈出院。出院后定期复查、化疗。随访1.5年无出血等征象。
We nearly 2 years admitted to the above gastrointestinal bleeding as the first symptom of primary splenic malignant tumor in 2 cases. The report is as follows. Example 1. Male, 63 years old. Due to repeated nausea, melena 3 years, 5 days vomit blood admitted to hospital. After admission, blood transfusions, hemostasis and other treatment 4 hours later, vomit blood about 400ml, solution of black will 1, the amount of about 150g, blood pressure 7 / 5kPa; emergency gastroscopy showed: gastric varices, gastric fundus nodular tumor. Splenectomy exploratory laparotomy found: the spleen increased, showing 10cm × 10cm and 4cm × 6cm, respectively, with the pancreatic body, tail, stomach fundus, body infiltration fusion, both tumors homogeneous hard, uneven. Stomach, varicose veins detour, splenectomy, pancreatic body, tail partial resection, partial resection of the stomach. Pathology report: Spleen cancer and pancreatic and gastric metastasis. No postoperative bleeding, infusion, anti-infective, chemotherapy and other treatments, hospitalized 20 days cured. After discharge regular review, chemotherapy. Follow-up 1.5 years without signs of bleeding.