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患者,男,47岁。1990年10月9日以上腹剧痛数分钟入院。体检:Bp 6.7/5.3 kPa(50/40mmHg),上腹有轻压痛,腹肌不紧张。化验:Hb 11.9％,粪便正常。CT发现肝左内叶有一占位病变,约6×4cm,腹腔内有少量积液。诊断:肝癌自发破裂。患者病情稳定后转北京医院,于1990年11月12日手术。证实肝左内叶肿块,约8×6×5cm,质硬,突出于肝表面,有包膜,部分溃烂;肝脏满布栗粒样结节,未见腹腔积液。作肝左内叶切除术。在分离过程中发现胃窦前壁有一圆形穿孔,约0.5cm,边缘整齐,内嵌一小块组织。将穿孔周围胃壁组织切除,修补穿孔。术后病检:1.肝细胞性肝癌。2.胃壁慢性炎症、纤维结缔组织增
Patient, male, 47 years old. On October 9, 1990, abdominal pain was admitted for several minutes. Physical examination: Bp 6.7/5.3 kPa (50/40mmHg), light tenderness on the upper abdomen, abdominal muscle tension. Laboratory tests: Hb 11.9%, normal feces. CT found a lesion in the left hepatic lobe, approximately 6 x 4 cm, with a small amount of effusion in the abdominal cavity. Diagnosis: Spontaneous rupture of liver cancer. After the patient became stable, he was transferred to a Beijing hospital and operated on November 12, 1990. The mass of the left internal lobe of the liver was confirmed to be approximately 8×6×5 cm. It was hard and protruded on the surface of the liver. The capsule was covered and some of them were ulcerated. The liver was covered with chestnut-like nodules and no effusion was observed. Liver left lobectomy. During the separation process, a circular perforation was found in the anterior wall of the gastric antrum, approximately 0.5 cm, with neat edges and a small piece of tissue embedded. Peripheral perforation of the gastric wall tissue was removed to repair the perforation. Postoperative disease examination: 1. Hepatocellular carcinoma. 2. Chronic inflammation of the stomach wall, fibrous connective tissue increase