论文部分内容阅读
本文报道1例卓-艾二氏(Zollinger-Ellison)综合征于全胃切除时残留了极小胃粘膜,又用 H_2受体拮抗剂治疗8个月,暴发性溃疡仍然产生,且并发了心包积气积脓。患者男性,55岁,因胸骨柄至脐间剧痛,于1978年3月13日入院。患者于1962年作胃次全切除术。1968、1971年发现吻合口溃疡。1971年空肠溃疡出血作胃和牌切除术,并切除了胰腺内的一个胰岛细胞瘤,全胃切除时,在食道下端残留了胃组织。1964、1971、1977年因高钙血症先后切除甲状旁腺腺瘤和增殖性腺体。1977年7月呕血,钡餐和纤维食管镜检查,发现胃空肠吻合口上1cm处,有1.5cm 溃疡1个,遂用甲氰咪胺等治疗,于入院前曾短期中断过。检查:T 38.3℃,血压118/66mmHg,脉搏72次/分,剧痛,结合膜苍白,心肺正常,足部有可凹性浮肿。
This article reports a case of Zollinger-Ellison syndrome in the gastrectomy residual minimal gastric mucosa, but also with H 2 receptor antagonist for 8 months, fulminant ulcers still occur, and complicated by pericardium Accumulation of empyema. The male patient, age 55, was admitted to hospital on March 13, 1978, due to severe pain in the sternum to the umbilical cord. Patients in 1962 for subtotal gastrectomy. 1968, 1971 found anastomotic ulcers. Jejunum ulcer bleeding in 1971 for gastric and brand resection, and removal of a pancreatic islet cell tumor, total gastrectomy, residual gastric tissue in the lower esophagus. 1964, 1971, 1977 due to hypercalcemia has cut off the parathyroid adenoma and proliferative glands. 1977 July hematemesis, barium meal and fiber esophagoscopy and found that gastrointestinal anastomotic 1cm Department, 1.5cm ulcer 1, then treated with cimetidine, etc., had a short interruption before admission. Check: T 38.3 ℃, blood pressure 118 / 66mmHg, pulse 72 beats / min, severe pain, combined with pale membrane, normal heart and lungs, the foot can have concave edema.