Subramaniam Daryl, Culshaw Nicholas, Langlands Fiona, Apthorp Lesley
Department of General Surgery, East Sussex Healthcare NHS Trust, St Leonards-on-Sea, East Sussex, UK.
BMJ Case Rep. 2013 Jan 24;2013:bcr2012006185. doi: 10.1136/bcr-2012-006185.
We present the case of an 82-year-old Caucasian lady with a 16-day history of colicky lower abdominal pain and reduced appetite. When presenting to hospital she was haemodynamically stable with no fever. Examination revealed a soft but tender abdomen with normal bowel sounds. No masses or hernias were present. Per-rectal examination revealed an empty rectum. Investigations showed raised inflammatory markers, white cell count 11.9 and C reactive protein 24, in addition to which she had dilated loops of small and large bowel on the abdominal radiograph. The patient underwent an emergency laparotomy where a mass in the descending colon was found to be intussuscepting into the proximal sigmoid colon for which a Hartmanns procedure was performed. Histopathology confirmed a Dukes B T3 N0 Mx adenocarcinoma.
我们报告一例82岁的白种女性患者，有16天的下腹部绞痛病史且食欲减退。入院时她血流动力学稳定，无发热。检查发现腹部柔软但有压痛，肠鸣音正常。未触及肿块或疝。直肠指检发现直肠空虚。检查显示炎症指标升高，白细胞计数11.9，C反应蛋白24，此外腹部X线片显示小肠和大肠肠袢扩张。患者接受了急诊剖腹手术，发现降结肠有一肿块套叠入近端乙状结肠，为此进行了哈特曼手术。组织病理学证实为Dukes B期T3 N0 Mx腺癌。
