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中华诊断学电子杂志

中华诊断学电子杂志 ›› 2018, Vol. 06 ›› Issue (01) : 61 -64. doi: 10.3877/cma.j.issn.2095-655X.2018.01.013

所属专题： 文献；

临床研究

完全内脏转位合并肠道肿瘤的诊断与治疗并文献复习
许志峰1, 李建军2,†(), 张保贵3   
  1. 1. 272067　济宁医学院
    2. 济宁医学院临床学院
    3. 272069　济宁医学院附属医院胃肠外科
  • 收稿日期:2017-10-23 出版日期:2018-02-26
  • 通信作者: 李建军
  • 基金资助:
    国家自然科学青年基金(81602160)

Diagnosis, treatment and literature review of situs inversus totalis combined with intestinal neoplasms

Zhifeng Xu1, Jianjun Li2,†(), Baogui Zhang3   

  1. 1. Department of Graduate School, Jining Medical University, Jining 272067, China
    2. Department of Clinical College, Jining Medical University, Jining 272067, China
    3. Department of Castrointestinal Surgery, Affiliated Hospital of Jining Medical University, Jining 272029, China
  • Received:2017-10-23 Published:2018-02-26
  • Corresponding author: Jianjun Li
  • About author:
    Corresponding author: Li Jianjun, Email:
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引用本文：

许志峰, 李建军, 张保贵. 完全内脏转位合并肠道肿瘤的诊断与治疗并文献复习[J/OL]. 中华诊断学电子杂志, 2018, 06(01): 61-64.

Zhifeng Xu, Jianjun Li, Baogui Zhang. Diagnosis, treatment and literature review of situs inversus totalis combined with intestinal neoplasms[J/OL]. Chinese Journal of Diagnostics(Electronic Edition), 2018, 06(01): 61-64.

目的

探讨完全内脏转位(SIT)合并肠道肿瘤患者的诊断与治疗。

方法

回顾性分析1例胸腹腔内脏完全转位合并结肠癌患者的临床表现和诊治过程，并检索2007至2017年的文献进行复习。

结果

患者临床表现为腹胀、贫血，胸腹部CT示：除心尖指向右以外，胸腹部组织器官完全反转；CT示肿瘤位于左侧，诊断为盲肠-升结肠癌；胃镜示胃转位。患者在全麻下行结肠癌根治术，术后病理示结肠腺癌。

结论

SIT患者由于腹腔器官转位，常出现位置相反的症状表现，常易导致误诊，应尽可能完善所有相关检查明确诊断及指导手术的顺利开展；诊断及治疗均应遵循"反向思维"的原则。此外，合并消化道肿瘤的SIT患者并非腹腔镜技术及机器人技术的手术禁忌，手术效果同样安全有效。

关键词: 内脏, 左右转位, 肠肿瘤, 诊断, 治疗
Objective

To investigate the diagnosis and treatment of situs inversus totalis (SIT) combined with intestinal neoplasms.

Methods

The clinical manifestations, diagnosis, and treatment of 1 patient with thoracic-abdominal visceral complete transposition and colorectal cancer was analyzed, and the literatures retrieved from 2007 to 2017 were reviewed.

Results

The clinical manifestations of the patient were abdominal distension and anemia.The chest and abdomen CT showed: the cardiac apex pointing forward to the right, the thoracic-abdominal tissues and organs completely reversed.Tumor was on the left side and was diagnosed as cecum and ascending colon cancer.Gastroscope showed gastric translocation.The patient underwent radical resection of colon cancer under general anesthesia, postoperative pathology showed colonic adenocar-cinoma.

Conclusions

Due to abdominal organ transposition, SIT patients often present opposite symptoms so that misdiagnosis is frequent.It should be as much as possible to complete all relevant tests to confirm the diagnosis and guide operation of the surgery.Diagnosis and treatment should follow the "reverse thinking" principle.In addition, SIT patients combined with digestive tract tumors are not contraindications for laparoscopic and robot surgery, the operation result is also safe and effective.

Key words: Viscera, Situs inversus, Intestinal neoplasms, Diagnosis, Treatment
图1 完全内脏转位合并肠道肿瘤患者影像学检查图像
图2 完全内脏转位并肠道肿瘤患者肿瘤切片病理学检查图像(HE ×200)。
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