回肠系膜英文

Preoperative diagnosis: intestinal obstruction: abdominal malignant tumors and intra-abdominal metastases mayIntraoperative diagnosis: ascending colon cancer and intra-abdominal metastasisRevised diagnosis: non Hodge's lymphoma of the ascending colon and extensive abdominal metastasisOperation name: laparoscopy + terminal ileum fistulationMethods: general anesthesia anesthesiaOperation: with the patient in the supine position after anesthesia, after the success of routine operation area disinfection auxiliary sterile towels, umbilical is about 25px long incision through the skin, pneumoperitoneum needle puncture into abdomen, into the CO2 gas, manufacturing pneumoperitoneum, reaching the pressure to turn into the sheath into the mirror, peritoneum, omentum, was found in the stomach wall, small intestine widely spread, e. surface diameter is not a white nodules, high about 75px, mesenteric and omental obvious edema, thickening, crisp texture, intestinal adhesion heavier, hepatorenal recess, right paracolic sulci and Dow cavity of visible light yellow clear ascites is about 150ml, further exploration of ileocecal to see near the hepatic flexure of the colon in a lump, about the size of 8*5*125px3, qualitative hard, mobility is poor, intraoperative diagnosis: ascending colon cancer and abdominal metastases, resection of the tumor was unable to judge, undergoing laparoscopic exploration of abdominal tumor biopsy + + terminal ileum fistulation. Are the left lower quadrant ventriculoperitoneal and lower right McBurney point is about 12.5px long, 25px incision, and then in the 5mm and 10mm Trocar, suction suction abdominal ascites, cut the size of about 3*1*25px3 with ultrasonic scalpel in omental tumor tissue, the specimen for pathological examination. Clamp the portion of terminal ileum intestinal wall, to be put to the abdominal wall, along the right lower quadrant Trocar qu-chang poke a hole about 125px incision, followed by skin incision, subcutaneous tissue, abdominal, the terminal ileum to the incision, separation of mesentery of small intestine, glass rod support, small intestinal longitudinal incision along the intestinal wall, about 50px long, 4-0 silk interrupted suture, to be II open, vaseline gauze intestinal wall, silk suture Trocar hole, a sterile dressing fixation, postoperative. The operation was successful, less bleeding, patients with stable vital signs, postoperative awake back ward.The pathological diagnosis of 1:Results, considered as a combination of HE and immune group: non Hodge's lymphoma involving the greater omentum".Tumor cells: LCA (+ +), PCK (-), CK7 (-), CK20 (-), HCK (-)Pathological diagnosis: 2 with HE and immunohistochemical results, considered as "(omentum) non Hodge's lymphoma, diffuse large B cell lymphoma".Tumor cells: LCA (+ +), CD20 (+ +), CD79a (+ +), CD3 (-), CD45RO (-)Findings:The liver was enlarged, homogeneous in density, smooth edge, liver, spleen week week see liquid density. After the resection of gallbladder was changed. The spleen is not big, smooth edge, no abnormal density range. Pancreatic morphology, size, density and no abnormal. The right lower abdominal see irregular soft tissue mass, and the unclear boundaries around the intestines, intestinal is much contents, and visible gas-liquid plane, abdominal mesenteric peritoneal thickening, which seems to see multiple small nodular high density. Renal morphology, size and density of no abnormal. Bilateral pleural effusion, left pleural thickening.Imaging diagnosis:1, consider the right lower abdominal neoplasms; mesenteric, peritoneal metastasis; ascites;In 2, intestinal obstruction, intestinal cavity is much;3, bilateral small pleural effusions; the left pleural thickening;4, after cholecystectomy change;Suggested that enhanced CT scan (fasting 'intestinal tract cleaning')