Burke Eoghan, Saeed Munir, Anant Paul, Sami Babur, Salama Mohamed, Ahmed Ibrahim
Department of Surgery, Our Lady Of Lourdes Hospital, Drogheda, Ireland.
J Surg Case Rep. 2018 Nov 13;2018(11):rjy304. doi: 10.1093/jscr/rjy304. eCollection 2018 Nov.
We present the case of a 46-year-old gentleman originally from China who presented to the acute surgical assessment unit complaining of upper abdominal discomfort, dyspepsia and early satiety ongoing for the previous 6 months. On exam he had a palpable mass in the left upper quadrant. He underwent an esophagogastroduodenoscopy which was normal and later received a CT abdomen which identified a well-circumscribed soft tissue mass in the mesenteric fat and lying adjacent to the transverse colon with no obvious cleavage plane between them. Colonoscopy was then performed which was normal. After discussion at MDT he was taken for laparotomy. At laparotomy the mass was found to be adherent to major vessels, small bowel and large bowel necessitating an extended right hemicolectomy and small bowel resection. The mass itself could not be completely excised. Histology from the resected specimen confirmed desmoid tumour.
我们报告一例46岁男性病例,该患者来自中国,因上腹部不适、消化不良和早饱感持续6个月,就诊于急性外科评估单元。检查时发现他左上腹有一可触及肿块。他接受了食管胃十二指肠镜检查,结果正常,随后进行了腹部CT检查,发现肠系膜脂肪中有一个边界清晰的软组织肿块,与横结肠相邻,两者之间无明显分界平面。接着进行了结肠镜检查,结果正常。多学科团队讨论后,他接受了剖腹手术。剖腹手术时发现肿块与大血管、小肠和大肠粘连,需要进行扩大右半结肠切除术和小肠切除术。肿块本身无法完全切除。切除标本的组织学检查证实为硬纤维瘤。