CAJ | 학술논문

目的探讨妊娠合并结肠肿瘤的误诊原因并提出预防措施。方法对1例误诊为腹壁下血肿的妊娠合并结肠肿瘤的临床资料进行回顾性分析。结果本例因停经28+2周、持续下腹痛伴阴道少量流血2 h入院，经妇科查体、血常规及B超等检查诊断为子痫前期(重度)、胎盘早剥、贫血(重度)。为挽救患者生命，急诊行剖宫产，术后对症治疗期间，患者出现左中腹疼痛，考虑腹壁下血肿、完全性肠梗阻，再次剖腹探查，术中见乙状结肠中段可触及15 cm×8 cm×4 cm大小的包块，术后病理诊断为(结肠)浆膜梭形细胞瘤。待患者病情平稳后转入普外科继续治疗。结论临床表现不典型、诊断思维局限及缺乏诊断经验是造成妊娠合并结肠肿瘤误诊的主要原因。
목적탐토임신합병결장종류적오진원인병제출예방조시。방법대1례오진위복벽하혈종적임신합병결장종류적림상자료진행회고성분석。결과본례인정경28+2주、지속하복통반음도소량류혈2 h입원，경부과사체、혈상규급B초등검사진단위자간전기(중도)、태반조박、빈혈(중도)。위만구환자생명，급진행부궁산，술후대증치료기간，환자출현좌중복동통，고필복벽하혈종、완전성장경조，재차부복탐사，술중견을상결장중단가촉급15 cm×8 cm×4 cm대소적포괴，술후병리진단위(결장)장막사형세포류。대환자병정평은후전입보외과계속치료。결론림상표현불전형、진단사유국한급결핍진단경험시조성임신합병결장종류오진적주요원인。
Objective To explore misdiagnosis causes of gestation complicated with colonic neoplasms and to provide preventive measures. Methods Clinical data of one patient with gestation complicated with colonic neoplasms misdiagnosed as having hematoma under abdominal wall was retrospectively analyzed. Results The patient was admitted for suppressed menstruation for 28 +2 weeks and continuous hypogastralgia with a small amount of vagina bleeding for 2 h. The diagnosis of pre-eclampsia (severe), placental abruption and anemia (severe) was given after gynecological examination, routine blood test and ultrasonography. The emergency cesarean delivery operation was performed to save the patient's life, but the patient had the left midabdomen pain during postoperative corresponding treatment, and then hematoma under abdominal wall and complete intestinal obstruction were suspected. A 15 cmí8 cmí4 cm lump in the middle of sigmoid colon was found during the exploratory laparotomy, and the serous spindle cell tumor of colon was confirmed by postoperative pathologic diagnosis. The patient was transferred to general surgery department for continous treatment after the condition became stable. Conclu-sion The main misdiagnosis causes of gestation complicated with colonic neoplasms are uncharacteristic clinical symptoms, limited diagnosis thinking and lack of clinical experience.