坏疽性阑尾炎致阑尾血管破裂出血一例报告

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1、坏疽性阑尾炎致阑尾血管破裂出血一例报告青海医药杂志2003年第33卷第9期Abdom.Imaging,1999,24:111～116.7DaviesJ,Chfllinel'sAG,Sue—LingHM,eta1.Spir~ctm~utedtctncgtaphyandoperativestagingofgastricCarcinoma:flcomparisonwithhistopathologicalstag—ing.Gut.1997,41:314～319.8陈竣青,张文范,王舒宝,等.胃癌外科治疗中的若干

2、问题.中华外科杂志,1991,29:220--223.?5?9TSuburayaA.NoguchiY,Matsm~toA,eta1.Apre—operativeassessmentofadjacentorganinvasionbystomachcardn~nawithhighresolutioncomputedto—mography.surgToday,1994,241:299--304.10AndakerL,MoralesO,HojerH,eta1.Evaluationofpre——operativec

3、omputedtomographyingastricmalignan—cy.Surgery,1991.109:132～135.APPLI(1oN0F耻LICALCI'DT—SrAG玎G0FGAICCANCERZhangJianguo,ZhangChengwu.DouLajia,YangShouren,BaoHaihua,MiaoWeiTheaffiliatedHospitalofQinghaiMedicalCollegeObjective:ToevaluatetheeffectsofhelicalCTon

4、diagnosisoflesioninT——stagingofgastriccan—cer.Methods:40csses,thoperativesta~nggastriccancerswereexaminedusinghelicalCTandtheresultsw℃recomparedwiththediagnosisofpathologyintheseobjects.Results:ThediagnosticaccuracyofhelicalCTonthesize,regionandtypeswere8

5、1.1%,88.7%and92.5%separately.Theaccuracyof~rouslesionwa$80.5%accordingtotheimagesofextra—stomachlipid.TheaccuracyofWas63.4%inbasisonthesignofoutlineofserOus.Conclusion:ThereisausingvaluationwhenthehelicalCTisapr~edtothediagnosisofadjacentlesioninpatientsw

6、ithgastriccarcinoma.K留wordsGastriccancer;HelicalCT;Evaluation;Diagnosis;Radiolc~y坏疽性阑尾炎致阑尾血管破裂出血一例报告青海省海南州人民医院普外科(813000)田尖参欧建患者,女,68岁,右下腹持续性疼痛,阵发性加剧6小时,伴发热,呕吐.以急性阑尾炎收入院.体温:38.4℃,脉搏I10分,血压80/50mmHg,腹部有压痛,以右下鹿为主,且伴肌紧张和反跳痛.Hb88g/L,WBC11×10'/L,N0.80.右下腹部穿刺抽得

7、血性脓液约4ml,直肠指检:直肠膀胱凹陷饱满,有压痛.B超提示;阑尾区团块回声,腹腔内液性暗区.手术所见:脓血性液300ml.凝血块200g.阑尾根部坏死,穿孔,有黄豆大粪石脱落于回盲部,阑尾血管破裂出血.切除阑尾残端结扎并作.z'.型缝合包埋,术后痊愈出院.病理报告:坏疽性阑尾炎,阑尾血管炎性断裂.讨论坏疽性阑尾炎腐蚀阑尾血管致破裂出血少见,临床上由于炎性症状与内出血症状并存.而炎性症状掩盖了内出血症状.给病变部位的确定带来困难,其出血原因可能为坏疽性阑尾炎炎症浸润腐蚀血管壁破损引起.本文一例为老年人,

8、受损血管难以自行收缩止血.也无高血压病史,术中应做监别诊断,详细观察和发现出血部位,否则遗漏其它脏器损伤出血.