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患者,女性,29岁。妊娠5个月,发现大便呈粘液脓性3～4次/日,伴腹痛和里急后重感。曾在当地医院按菌痢治疗无效。体检:消瘦,贫血貌。下腹部隆起。肛检距齿状线3cm处触及一赘生物,呈环状生长,致肠腔明显狭窄,仅容一小指尖通过。左锁骨上触及多个肿大淋巴结。剖腹探查发现双侧卵巢肿大,子宫孕5个月。直肠肿物固定并侵及阴道后壁,已无法切除,行乙状结肠造瘘术加全子宫及双侧附件切除,直肠肿块和左销骨上淋巴结活检。术后6个月死于恶液质和肿瘤转移。
Patient, female, 29 years old. In 5 months of pregnancy, it was found that the stool was mucinous and purulent 3 to 4 times/day, with abdominal pain and tenesmus. In the local hospital, it was not effective to treat bacillary dysentery. Physical examination: weight loss, anemia appearance. Lower abdomen bulges. The rectum was 3cm away from the dentate line and touched a worm. It grew in a ring shape, causing the intestine to become narrow, allowing only a small fingertip to pass through. The left clavicle touched several enlarged lymph nodes. A laparotomy revealed bilateral ovarian enlargement and the uterus was pregnant for 5 months. The rectal tumors were fixed and invaded the posterior vaginal wall and could not be removed. The sigmoid colostomy combined with full uterus and bilateral appendage resection was performed. The rectal masses and the lymph nodes on the left pin were biopsied. Six months after surgery, he died of cachexia and tumor metastasis.