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根据B超、X线及CT扫描提示,诊断为左上腹部畸胎瘤。因此病人于入院后第六天上午八时在硬膜外麻醉下剖腹探查,术中腹腔内未发现肿瘤。经检查,诊为胸腔内占位。遂关闭原切口,改全麻,开胸探查,术中发现肿物位于左胸腔下部,膈面与左肺下叶之间,有蒂位于膈、心包纵隔部呈带状,肿块与横膈、肺下缘及心包之间有疏松粘连。肿块大小为18.0cm×17.0cm×l6.5cm,包膜完整,质硬为实质性,表面光滑。分开粘连,钳夹断其蒂,将肿物整个切除,称重为2366g。术后诊断:下纵隔畸胎瘤。
According to the B-ultrasonography, X-ray, and CT scans, the diagnosis was a teratoma in the left upper quadrant. Therefore, the patient underwent laparotomy under epidural anesthesia at 8 o’clock on the sixth day after admission. No intratumoral tumor was found during the operation. After examination, the diagnosis was a chest cavity occupation.遂 Close the original incision, change the general anesthesia, and open the chest for exploration. The intraoperative findings revealed that the tumor was located in the lower part of the left chest cavity, between the diaphragm surface and the left lower lobe. The pedicle was located in the diaphragm, and the pericardial septum was banded. The lumps and diaphragm were located. There is loose adhesion between the lower lung and the pericardium. The size of the mass was 18.0cm×17.0cm×l6.5cm. The capsule was complete, hard and substantive, and the surface was smooth. Separated the adhesions and clamped off their pedicles. The entire tumor was resected and weighed 2366 g. Postoperative diagnosis: inferior mediastinal teratoma.