胰腺导管内乳头状黏液性肿瘤合并胆管癌1例报告
1病例资料 患者男性，65岁，因“上腹部不适半月余，巩膜黄染1 d”于2014年11月23日入本院治疗。入院时精神状态可，食欲欠佳，偶有恶心，无呕吐，无畏寒、发热。既往体健。入院时查体：皮肤、巩膜轻度黄染，腹平坦，未见胃肠型及蠕动波，腹壁静脉未见曲张，腹软，右上腹部可触及一大小约3 cm ×3 cm 质软包块，活动度欠佳，触之无肌紧张及反跳痛，肝脾肋下未触及。肝功能：AST 296 U／L，ALT 305 U／L，GGT 676 U ／L，ALP 141 U ／L，TBil 24．2μmol ／L，DBil 11．1μmol ／L，IBil 13．1μmol ／L。肿瘤标志物：CA24－245...
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| Published in | 临床肝胆病杂志 Vol. 33; no. 1; pp. 169 - 170 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | Chinese |
| Published |
吉林大学白求恩第一临床医院 肝胆胰外科,长春,130021
2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1001-5256 |
| DOI | 10.3969/j.issn.1001-5256.2017.01.039 |
Cover
| Abstract | 1病例资料
患者男性，65岁，因“上腹部不适半月余，巩膜黄染1 d”于2014年11月23日入本院治疗。入院时精神状态可，食欲欠佳，偶有恶心，无呕吐，无畏寒、发热。既往体健。入院时查体：皮肤、巩膜轻度黄染，腹平坦，未见胃肠型及蠕动波，腹壁静脉未见曲张，腹软，右上腹部可触及一大小约3 cm ×3 cm 质软包块，活动度欠佳，触之无肌紧张及反跳痛，肝脾肋下未触及。肝功能：AST 296 U／L，ALT 305 U／L，GGT 676 U ／L，ALP 141 U ／L，TBil 24．2μmol ／L，DBil 11．1μmol ／L，IBil 13．1μmol ／L。肿瘤标志物：CA24－245．37 U ／ml， CA19－9110．98 U ／ml ，CEA 4 ng／ml。血常规、血淀粉酶无异常。肝胆脾胰多排 CT 平扫＋三期增强（图1a ～h）示：胆总管扩张，宽约1．9 cm，局部可见结节样软组织影，大小约2．0 cm，增强扫描可见明显强化。胰头部见一不规则结节样低密度影，大小约3．0 cm，其内可见分隔，局部可见与胰管沟通，增强扫描边缘及分隔强化，呈延迟强化，胰腺体尾部形态尚可，胰管未见明显扩张。胆道核磁水成像（图1i）示：胆总管扩张，走行至胆总管末端截断。术前诊断考虑：梗阻性黄疸，胆总管末端占位性病变，胰腺占位性病变，胰腺囊腺瘤可能性大。 |
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| AbstractList | R735.8%R735.9 1病例资料 患者男性，65岁，因“上腹部不适半月余，巩膜黄染1 d”于2014年11月23日入本院治疗。入院时精神状态可，食欲欠佳，偶有恶心，无呕吐，无畏寒、发热。既往体健。入院时查体：皮肤、巩膜轻度黄染，腹平坦，未见胃肠型及蠕动波，腹壁静脉未见曲张，腹软，右上腹部可触及一大小约3 cm ×3 cm 质软包块，活动度欠佳，触之无肌紧张及反跳痛，肝脾肋下未触及。肝功能：AST 296 U／L，ALT 305 U／L，GGT 676 U ／L，ALP 141 U ／L，TBil 24．2μmol ／L，DBil 11．1μmol ／L，IBil 13．1μmol ／L。肿瘤标志物：CA24－245．37 U ／ml， CA19－9110．98 U ／ml ，CEA 4 ng／ml。血常规、血淀粉酶无异常。肝胆脾胰多排 CT 平扫＋三期增强（图1a ～h）示：胆总管扩张，宽约1．9 cm，局部可见结节样软组织影，大小约2．0 cm，增强扫描可见明显强化。胰头部见一不规则结节样低密度影，大小约3．0 cm，其内可见分隔，局部可见与胰管沟通，增强扫描边缘及分隔强化，呈延迟强化，胰腺体尾部形态尚可，胰管未见明显扩张。胆道核磁水成像（图1i）示：胆总管扩张，走行至胆总管末端截断。术前诊断考虑：梗阻性黄疸，胆总管末端占位性病变，胰腺占位性病变，胰腺囊腺瘤可能性大。 |
| Author | 李兆鑫 马文聪 张平 |
| AuthorAffiliation | 吉林大学白求恩第一临床医院肝胆胰外科,长春130021 |
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| Author_FL | LI Zhaoxin MA Wencong ZHANG Ping |
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| DocumentTitleAlternate | A case of intraductal papillary mucinous neoplasm with cholangiocarcinoma |
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| Keywords | 胆管肿瘤 case reports 病例报告 bile duct neoplasms pancreatic neoplasms 胰腺肿瘤 |
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| Notes | pancreatic neoplasms; bile duct neoplasms; case reports LI Zhaoxin, MA Wencong, ZHANG Ping. （Department of Hepatopancreatobiliary Surgery, The First Hospital of Jilin University, Changchun 130021, China） 22-1108/R |
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| Snippet | 1病例资料
患者男性，65岁，因“上腹部不适半月余，巩膜黄染1 d”于2014年11月23日入本院治疗。入院时精神状态可，食欲欠佳，偶有恶心，无呕吐，无畏寒、发热。既往体健。入院时查体：皮肤、巩膜轻度黄染，腹平坦，未见胃肠型及蠕动波，腹壁静脉未见曲张，腹软，右上腹部可触及一大小约3 cm ×3 cm... R735.8%R735.9 |
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| SubjectTerms | 病例报告 胆管肿瘤 胰腺肿瘤 |
| Title | 胰腺导管内乳头状黏液性肿瘤合并胆管癌1例报告 |
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