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硬化性肠系膜炎症作为腹痛和腹内肿块的罕见病因:一例病例报告及文献综述

Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature.

作者信息

Gu Guo-Li, Wang Shi-Lin, Wei Xue-Ming, Ren Li, Li De-Chang, Zou Fu-Xian

机构信息

Department of General Surgery, the General Hospital of Chinese PLA Air force, Beijing 100142, PR China.

出版信息

Cases J. 2008 Oct 16;1(1):242. doi: 10.1186/1757-1626-1-242.

Abstract

Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper.

摘要

硬化性肠系膜炎是一种罕见的、良性的慢性纤维性炎症疾病,病因不明,可累及小肠和结肠的系膜。该疾病有两种公认的组织学类型:急性或亚急性形式称为肠系膜脂膜炎,慢性形式称为回缩性或硬化性肠系膜炎。由于硬化性肠系膜炎缺乏特殊的临床表现和典型体征,因此患者很容易被误诊。硬化性肠系膜炎的正确诊断依赖于病理检查和剖腹探查术。我们报告一例52岁男性硬化性肠系膜炎患者,该患者表现为慢性腹痛和腹内肿块。此患者有长期大量饮酒史。他经CT检查被误诊为腹腔畸胎瘤,于2004年3月2日接受了剖腹探查术。在回肠末端系膜中发现一个直径约5厘米的肿块。尽管有几段小肠紧密附着于肿块,但受累肠段并无梗阻。术中活检表明这是一个炎性肿块。肿块及粘连的肠段被切除。通过石蜡切片的组织病理学检查,他被诊断为硬化性肠系膜炎。术后,该患者恢复良好,在撰写本文时未复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf4a/2572604/fb996d75081d/1757-1626-1-242-1.jpg

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