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患者男,4岁。因食欲不振三周,腹胀一周伴恶心、呕吐来诊,查体:腹部膨隆,胀满,轻度发热,门诊以“腹腔肿物”收入院。超声所见:腹膜后左肾内下方见18.6×17.5×12.5cm实性肿物,边界清晰,内见散在的液性暗区,左肾集合系统被肿物占据,上半部集合系统分离宽径约0.9cm,右肾大小约5.9×3.7cm,未见积液及占位性病变,腹腔内见深约5.0cm液性暗区。超声提示:1.腹膜后肿物考虑肾胚胎瘤;2.腹水。经过化疗后包块减小,20天后彩超复查:包块大小约14.8×9.0×8.4cm。 全麻下行左腹膜后肿物切除术,术中见肿物巨大,与周边粘连重,前上粘连胰腺,内侧为十二指肠,前方为降结肠,肿物向腹腔突出,右肾完整,位于肿瘤外侧,切开肿瘤时,瘤包
Patient male, 4 years old. Due to loss of appetite for three weeks, bloating week with nausea, vomiting, physical examination: abdominal bulging, fullness, mild fever, outpatient “abdominal mass” income hospital. Ultrasound see: retroperitoneal see the bottom of the left kidney 18.6 × 17.5 × 12.5cm solid tumor, the boundary is clear, see scattered liquid dark area, the left renal collecting system is occupied by the tumor, the upper half of the collection system is wide Diameter of about 0.9cm, the size of the right kidney about 5.9 × 3.7cm, no effusion and space-occupying lesions, intra-abdominal see a depth of about 5.0cm liquid dark area. Ultrasound Tip: 1. Retroperitoneal tumor to consider renal embryo; 2 ascites. After chemotherapy to reduce the mass, 20 days after the color Doppler ultrasound examination: mass size of about 14.8 × 9.0 × 8.4cm. Under general anesthesia for left retroperitoneal tumor resection, the surgery see the huge mass, with the surrounding adhesions heavy, before the adhesion of the pancreas, the medial duodenum, the descending colon in front of prominent tumor to the abdominal cavity, right kidney integrity, Located outside the tumor, incision tumor, tumor bag