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患者,女性,28岁,因间歇性右上腹胀痛半年,加重伴呕吐1周入院.查体;右上腹深部可触及一鸡蛋大小的包块,质韧,边界不清,无压痛,似可推动、余未见阳性体征.超声检查,胃内较多水样潴留物,在十二指肠左后方,胰头偏下见5.3 ×3.6cm椭圆形实质性中等强度回声包块,边界清晰,轮廓光整,内部回声较均匀,中央部见散在强回声光点,后方回声略增强.多普勒显示周边部动静脉血流信息丰富(图 1).肝、胆、胰脾及双肾均未见异常.超声诊断:右上腹腔内实质性占位病变,多考虑异位胰腺并发胰腺癌.手术所见,十二指肠降部内侧壁处见一包块,与周围组织无明显粘连,局部十二指肠明显狭窄.术中冰冻切片诊断胰腺癌.探查胰腺正常.行十二指肠大部切除,胃空肠吻合术.术后病理诊断:异位胰腺并发胰腺癌.
Patients, female, 28 years old, suffering intermittent pain in the right upper quadrant for six months, aggravated vomiting for 1 week and hospitalized; physical examination; deep right upper quadrant can touch an egg-sized mass, tough, unclear boundaries, no tenderness, and may promote No positive signs were observed. Ultrasound examination revealed that there were more water-like retention materials in the stomach. In the left rear part of the duodenum, see 5.3 × 3.6cm oval-shaped substantial medium-intensity echo mass with clear boundaries. Smoothness, the internal echo is more uniform, the central part sees a strong echo, and the back echo is slightly enhanced. Doppler shows abundant peripheral arteriovenous blood flow information (Figure 1). Liver, gallbladder, pancreas and spleen, and both kidneys are No abnormalities. Ultrasound diagnosis: Substantial space-occupying lesions in the right upper abdominal cavity, and more consideration of ectopic pancreatic pancreatic cancer. Seen from the operation, there was a mass in the medial side wall of the descending duodenum with no obvious adhesion to the surrounding tissue. Local duodenal stenosis. Intraoperative frozen section diagnosis of pancreatic cancer. Exploration of the normal pancreas. Subtotal duodenal resection, gastrojejunostomy. Postoperative pathological diagnosis: ectopic pancreatic pancreatic cancer.