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答案:1、C;2、A解释:本期病例经腹腔CT增强扫描诊断为胰腺尾部癌。CT表现为胰腺尾部明显增大,密度稍低,边界欠清,动脉期未见明显强化;脾静脉及左肾上腺受累,腹膜后淋巴结肿大(见图1)。由于患者年龄大,考虑手术风险较大,家属及本人决定保守治疗。胰腺肿瘤早期一般无明显临床表现,在B超、CT等影像学检查中显示低密度病灶,累及脾静脉时可引起脾静脉回流受阻,从而导致区域性门脉高压。区域性门脉高压的特点为常常没有食管静脉曲张,而表现为孤立性胃静脉曲张,主要分布在胃底、贲门甚至胃体,形态为结节、葡萄串、迂曲条索状及树枝丛状为多见;后期亦可出现食管静脉曲张,临床上易误判为肝硬化门脉高压。孤立性胃静脉曲张破裂出血可导致死亡。本病明确诊断后,外科手术治疗切除病灶可使孤立性胃静脉曲张消退。
Answer: 1, C; 2, A explanation: The current cases of abdominal CT enhanced scan diagnosis of pancreatic cancer. CT showed a significant increase in the tail of the pancreas, the density is lower, the border is not clear, no significant enhancement during the arterial phase; splenic vein and left adrenal involvement, retroperitoneal lymph nodes (see Figure 1). As the patient is older, considering the greater risk of surgery, family and I decided to conservative treatment. Early pancreatic cancer generally no obvious clinical manifestations, B-scan, CT and other imaging studies showed low-density lesions, involving the splenic vein spasm can cause obstruction, resulting in regional portal hypertension. Regional portal hypertension is often without esophageal varices, and the performance of isolated varicose veins, mainly in the gastric fundus, cardia or even gastric body, the shape of nodules, grapes, tortuous cord-like branches and plexuses As more common; Late esophageal varices may also occur, clinically miscarried cirrhosis portal hypertension. Isolated gastric variceal bleeding can result in death. After the diagnosis of this disease is clear, surgical resection of lesions can isolate solitary gastric varices subsided.