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1
題名:Huge Mesenteric Teratoma Encasing the Superior Mesenteric Artery and Vein: Report of a Case     (8點)
包埋腸系膜動靜脈的巨大畸胎瘤:病例報告
著者:Yu-Chih Liu(劉育志) ;Chih-Ming Huang(黃致旻) ;Chau-Jing Chen(陳肇真)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:mesenteric teratoma ; supior mesenteric artery and vein
刊名:Formosan journal of surgery
卷期:44卷1期(2011.2)
頁碼:23-26
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

一位十個月大的男嬰,因為兩個多月來進行性的 腹脹,食慾變差而就醫O 腹部電腦斷層發現一個十五 公分大的腸系膜內畸胎瘤,由橫隔下方一直延伸到骨 盆腔。一段五公分長的上腸系膜動脈及上腸系膜靜脈 完全被包埋在腫瘤之內。于術進行時,在包埋於腫瘤 內的上腸系膜動脈處,分離腫瘤變得相當困難,而意 外將之截斷。小腸的色澤變得蒼白,但在幾分鐘後又 逐漸恢復紅潤。在完全切除腫瘤之後,上腸系膜動脈 及上腸系膜靜脈的斷端被順利地接合。吻合之後,小 腸的色澤與懦動均相當正常。患者於術後第五天出 院。巨大腸系膜內畸胎瘤是相當少見的生殖細胞瘤O 腫瘤完全切除是主要的預後因于。而緊密包埋上腸系 膜動靜脈的巨大腸系膜內畸胎瘤之切除,依舊是外科 醫師的一項挑戰o 在此一患者,因為上腸系膜動脈受 到長期壓迫,而逐漸發展出側枝循環系統,讓上腸系 膜動脈在意外截斷之後,仍能提供小腸足夠的血流供 應。
A 10-month-old male infant suffered from progressive abdominal distention and poor appetite for 2-months. Computed tomography revealed a mesenteric teratoma, 的cm in diameter, extending from the subhepatic area to the pelvic cavity with the small intestine displaced caudally and to the left side of the pelvis. Both the superior mesenteric artery (SMA) and vein were encased within the tumor for the length of at least 5 cm. During operation, tumor was initially dissected through the plane beneath the elevated small bowel mesentery, and the procedure proved rather difficult as the SMA emerged from the tumor, which was accidentally divided. The small bowel turned pale immediately but became pink in color several minutes later. After excision of the tumor, the severed ends of the SMA and SMV were anastomosed smoothly. The color and peristalsis of the small bowel were normal after anastomosis. The patient was discharged on the 5th postoperative day. Mesenteric teratoma is an extremely rare tumor of the germ cells. Complete tumor resection is the main prognostic factor for survival in such cases. Therefore, an important factor for successful surgery is the exact preoperative visualization of the extent of the tumor and meticulous intra-operative assessment of the collateral vasculature. A huge mesenteric teratoma in children, encasing the root of the mesenteric vessels tightly, presents a management challenge to the surgeon. In this particular case, the reversibility of small bowel ischemia caused by accidental severance of the SMA is thought to be due to gradual development of abundant collateral circulation to the small bowel during prolonged compression of the SMA.


    

本卷期目次
Formosan journal of surgery 44卷1期 (2011.2)
A Look at the History of Surgery for Pectus Excavatum/ Chih-Chun Chu
Different Modes of Clinical Progress between Parkinsonian Patients with and without Subthalamic Deep Brain Stimulation/ Tomor HarnodShu-Hui WenShin-Yuan Chen
Human Pulmonary Dirofilariasis: Report of a Case/ Hao-Cheng ChangYi-Cheng WuShih-Chiang HuangChi-Wei WangYen Chu
Huge Mesenteric Teratoma Encasing the Superior Mesenteric Artery and Vein: Report of a Case/ Yu-Chih LiuChih-Ming HuangChau-Jing Chen
Intravesical Migration of Intrauterine Device Resulting in Bladder Stone: Report of a Case/ Mao-Sheng LinChi-Hsiang WuHuei-Loong HsiehTah-Chong LinChao-Chih ChenEugene LinChien-Hsiang Wang
A Giant Acrochordon on the Nipple: Report of a Case/ Hui-Ling PengTsui-Fen ChengLiang-Kuang ChenCheng-Tau SuDong-Ron Chen
Hemodynamic Instability in a Major Burn Patient Associated with Asymptomatic Iatrogenic Adrenal Insufficiency: Report of a Case/ Tyng-Luen RoanEng-Kean YeongYueh-Bih Tang
Minimally Invasive Total Knee Arthroplasty/ Wei-Pin Ho
 
   
 
   

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