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患者男性,41岁,因上腹部包块3个月,于1991年11月26日入院。患者1971年10月因上腹部疼痛在外院诊断为“十二指肠球部溃疡并幽门梗阻”,行“胃大部切除术(BillrothⅡ式)”。1991年5月因腹部隐痛在外院诊断为“空肠肿瘤”,行剖腹探查,术中见空肠上段有多个息肉状肿物,仅切取一个肿物送病检。近3个月发现上腹部包块,伴有呕吐,为胃内食物,无呕血及黑便。查体:营养差,消瘦,贫血貌。左上腹部触及一10cm×8cm×6cm大小的包块,质韧,边界不清,稍活动,无触痛,口腔粘膜及四肢皮肤未见有色素沉着斑。上消化道钡透:胃腔内造影剂通过缓慢,胃粘膜呈网络状改变。胃镜:贲门以下有多个隆起性息肉状肿物,广基无蒂,粘膜光整,胃空肠吻合口处被多个息肉状肿物阻
The patient was a 41-year-old man who was admitted to the hospital on November 26, 1991 because he had an upper abdominal mass for 3 months. In October 1971, the patient was diagnosed as having a duodenal ulcer and a pyloric obstruction due to epigastric pain in the external hospital. He underwent a “subtotal gastrectomy (Billroth type II)”. May 1991 due to abdominal pain in the external hospital diagnosed as “jejunum tumor”, laparotomy exploration, intraoperative jejunum had multiple polypoid masses, only cut a tumor to send a medical examination. In the past 3 months, abdominal masses were found with vomiting, food in the stomach, no hematemesis and black stools. Physical examination: poor nutrition, weight loss, anemia appearance. The upper left abdomen touched a lump of 10cm x 8cm x 6cm in size, tough, unclear borders, slightly active, no tenderness, no pigmentation spots on the oral mucosa and limb skin. Upper Gastrointestinal Permeation: The contrast agent in the gastric cavity passes slowly, and the gastric mucosa changes in a network. Gastroscope: There are multiple raised polypoid masses below the fontanelle, wide base pedicle, mucosal smoothing, and multiple polypoid masses at the gastrojejunostomy.