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胃腺癌和成年中肠逆转:一个罕见的手术内发现
Marisa Ferreira1, Rita Banza1, Ana S Dias1
1General Surgery, Unidade Local De Saúde Região De Leiria, Leiria, PRT.
Cureus
|March 16, 2026
概括
本案例报告描述了一例罕见的偶然中肠恶性旋转 (MM),在一名老年妇女的胃癌手术中发现. 识别这种异常对于安全的手术规划和患者的治疗结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 遗传异常是一种先天性异常.
背景情况:
- 中肠恶性旋转 (MM) 是一种先天性异常,通常在婴儿期被诊断出来.
- 在成年人中偶然检测到MM是罕见的.
- 毫米瘤和胃恶性瘤之间的关联非常罕见,并对手术规划构成挑战.
研究的目的:
- 在一个老年患者中呈现胃腺癌的病例,偶尔发现了中肠恶性旋转.
- 强调在瘤胃外科手术期间识别解剖变异的重要性.
- 讨论外科手术规划和手术内决策方面的影响.
主要方法:
- 一个78岁的妇女的病例报告,患有胃恶性瘤的症状.
- 诊断工作包括上部内镜和CT扫描.
- 手术管理涉及开放的子总胃切除术与Billroth II胃肠结节术.
- 在手术期间发现中肠恶性旋转 (Treitz带侧向十二指肠的第二部分).
主要成果:
- 胃腺癌 (发达的扩散型) 经由他的病理学证实.
- 在手术期间发现了偶然的中肠恶性旋转.
- 由于无症状呈现,患者在没有MM纠正的情况下成功进行了胃切除术.
- 手术后的过程是没有事件的.
结论:
- 在胃癌手术过程中可以遇到意想不到的解剖变异,例如中肠恶性旋转.
- 个性化管理和手术内意识是安全的手术决策的关键.
- 这一案例强调了在复杂的外科病例中需要仔细进行手术前评估和手术内警的必要性.
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