论文部分内容阅读
患者男,23岁。阵发性上腹痛7个月,夜间及阴雨天加重,左侧卧位减轻,伴有食欲减退,体重下降。查体:Bp140/96mmHg,P84次/分。巩膜、皮肤无黄染及出血点,表浅淋巴结不大。腹平软,左上腹部可扪及一鸡蛋大小之圆形肿块,界限不清,质较软,触痛(+)。B型超声波显示胰尾部有4.7×4.5cm边缘光滑的圆形肿块。CT扫描腹主动脉与胰尾之间可见4×4.5cm边缘不太光滑的密度增高肿块,提示后腹腔实质性肿物。临床诊断为:腹膜后神经源性肿瘤。在硬膜外麻醉下行剖腹探查术。术中见腹膜后小肠系膜根部一鸡蛋大小肿物,无完整包膜,表面不光滑,满布血管,与腹主动脉粘连甚密,行肿瘤切除术。血压术中达140～180/80～120 mmHg,术毕130/80mmHg,出院时120/80mmHg。病理诊断:化学感受器瘤。
The patient is 23 years old. Paroxysmal epigastric pain for 7 months, night and rainy days, aggravate the left lying position, accompanied by loss of appetite, weight loss. Physical examination: Bp140/96mmHg, P84 beats/min. Sclera, skin without yellow stains and bleeding, superficial lymph nodes are not large. The abdomen is soft, and the upper left abdomen can lick a round lumps of an egg size with unclear boundaries, soft, tender (+). B-mode ultrasound showed a rounded, round lumps of 4.7 x 4.5 cm in the tail of the pancreas. CT scan showed a 4 × 4.5 cm density-growth mass between the abdominal aorta and the pancreatic tail, suggesting a solid mass in the abdominal cavity. Clinical diagnosis: Retroperitoneal neurogenic tumors. A laparotomy is performed under epidural anesthesia. Intraoperative retroperitoneal small mesenteric root an egg size tumor, no complete capsule, the surface is not smooth, covered with blood vessels, adhesion with the abdominal aorta is very dense, line tumor resection. Intraoperative blood pressure reached 140 to 180/80 to 120 mmHg, 130/80 mmHg after surgery, and 120/80 mmHg at discharge. Pathological diagnosis: chemoreceptor tumors.