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何某,女,11岁。因腹痛、发热四天入院。入院时体温37℃。查体:全腹膨隆,触诊全腹压痛,腹硬,疑有肿块。要求B超检查。使用仪器:Aloka SSD 610,探头频率3.5MHz。B超所见:肝胆明显上移,腹腔内探及巨大实质不均质肿块:内为不规则高回声与大小不等的囊性暗区相间。肿块上自剑突下及肝下缘,下至耻骨联合,左右未探及边界,前方为腹膜,后方至脊椎,肿块外形不规则,末探及包膜。B超诊断:腹腔内巨大实质性不均质性肿块,考虑畸胎瘤。 手术所见:肿块根部与结肠系膜相连,不易分离,切除带有肿块的结肠30cm。肿块重2.5kg。 病理检查:外观:暗红色实质性肿块,质硬。切面:多房囊变。镜检:毛细血管、平滑肌组织,纤维组织,脂肪组织淋巴泡交互混杂,符合错构瘤的诊断。
Hemou, female, 11 years old. Due to abdominal pain, fever four days admitted. Admission temperature 37 ℃. Examination: bulging abdomen, palpation of abdominal pain, abdominal stiffness, suspected lumps. Requires B-ultrasound. Instrument: Aloka SSD 610, probe frequency 3.5MHz. B seen: liver and gallbladder was significantly shifted, intra-abdominal exploration and huge heterogeneous lumps of mass: irregular high echo and cystic dark areas of varying sizes. Lumps from the xiphoid and the lower edge of the liver, down to the pubic symphysis, left and right not to explore and the border, in front of the peritoneum, the rear to the spine, the mass irregular shape, the end of exploration and envelope. B-ultrasound: a huge intra-abdominal mass heterogeneous mass, consider teratoma. Surgical findings: the mass of the root and the mesocolon connected, difficult to separate, remove the mass with the colon 30cm. Mass 2.5kg. Pathological examination: Appearance: dark red substantive mass, hard. Section: more than one capsule change. Microscopic examination: capillaries, smooth muscle tissue, fibrous tissue, adipose tissue lymphocytes mixed, in line with the diagnosis of hamartoma.