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患者男,23岁。2001年6月23日突然上腹部阵发性疼痛,初为上腹痛,后渐移至右下腹部。在外院拟诊为阑尾炎,治疗效果不显著。2个月后复诊,于右下腹扪及一拇指样条状肿物,硬,中等活动,微压痛,大便隐血(+)。4个月后就诊我院,以右下腹部肿物收入院。查体:营养状况较好,发育正常,全身表浅淋巴结无肿大。心肺听诊二尖瓣区可听到Ⅱ级收缩期杂音,两肺呼吸音清晰。腹部平坦,右下腹马氏点处可触到一圆形肿物,4cm×6cm,边缘清楚,表面光滑,活动,微压痛。实验室检查:WBC9.25×10~9/L,中性0.80,淋巴0.15,血沉正常。X线钡灌肠检查发现盲肠、升结肠交界处(回盲瓣附近)肠管内侧壁有一圆形、边缘光滑锐利的充盈缺损,直径约4cm。附近结肠壁尚柔软,结肠袋无明显异常。经按压后仰卧位摄片,
Male patient, 23 years old. June 23, 2001 Sudden abdomen paroxysmal pain, the beginning of the upper abdominal pain, after gradually moving to the right lower abdomen. Appendicitis in the external hospital diagnosed, the treatment effect is not significant. Two months after the referral, palpable thumb-like tumor in the right lower quadrant, hard, moderate activity, slight tenderness, fecal occult blood (+). 4 months after visiting our hospital to the right lower abdomen tumor hospital. Physical examination: good nutritional status, normal development, systemic superficial lymph nodes without swelling. Cardiorespiratory auscultation mitral valve area can hear Ⅱ systolic murmur, clear breath sounds of both lungs. Abdomen flat, right lower quadrant Ma point can touch a round tumor, 4cm × 6cm, clear edge, smooth surface, activity, slight tenderness. Laboratory tests: WBC9.25 × 10 ~ 9 / L, neutral 0.80, lymph 0.15, erythrocyte sedimentation rate normal. X-ray barium enema examination showed that the cecum, ascending junction junction (near the ileocecal valve) intestinal wall has a round, smooth and sharp edge of the filling defect, a diameter of about 4cm. Colon near the wall is still soft, no significant abnormal colon bag. After pressing supine position radiography,