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胃和食管双原发癌合并内脏反位及多脾畸形:术前评估的重要性

Double cancer of the stomach and oesophagus with situs ambiguus with polysplenia: the importance of preoperative evaluation.

作者信息

Park S-S, Min B-W, Kim W-B, Han H-J, Yong H-S, Kim S-J, Kim C-S, Mok Y-J

机构信息

Department of Surgery, Korea University College of Medicine, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea.

出版信息

Dig Liver Dis. 2005 Oct;37(10):799-802. doi: 10.1016/j.dld.2005.02.013.

Abstract

A rare case of double cancer with situs ambiguus with polysplenia is presented. A 58-year-old patient was initially diagnosed with an early gastric cancer. On evaluation, the computed tomography of the abdomen demonstrated situs ambiguus with polysplenia. We performed a subtotal gastrectomy with the stomach being reconstructed in a Billroth-II fashion. Three months after the operation, he again visited our department complaining nausea and dysphagia. Examinations confirmed the other oesophageal malignancy with advanced stage. Because of unfamiliarity to situs anomaly and rarity of double cancer, we missed the other coexistent cancer. This is the first case presentation of a double carcinoma occurring in a patient with situs ambiguus with polysplenia. The literature is reviewed and the importance of preoperative evaluation is discussed.

摘要

本文报告一例罕见的并存多脾综合征的内脏反位双癌病例。一名58岁患者最初被诊断为早期胃癌。经评估,腹部计算机断层扫描显示为并存多脾综合征的内脏反位。我们实施了胃次全切除术,并采用毕罗Ⅱ式重建胃。术后三个月,他因恶心和吞咽困难再次就诊。检查确诊为另一例晚期食管恶性肿瘤。由于对内脏反位异常不熟悉且双癌罕见,我们漏诊了另一例并存的癌症。这是首例并存多脾综合征的内脏反位患者发生双癌的病例报告。本文回顾了相关文献并讨论了术前评估的重要性。

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