胆囊十二指肠瘘伴胆石性肠梗阻合并结肠癌1例报告

李文波; 李良; 姜友; 张军; 鲁俊

doi:10.3969/j.issn.1001-5256.2023.04.024

胆囊十二指肠瘘伴胆石性肠梗阻合并结肠癌1例报告

DOI: 10.3969/j.issn.1001-5256.2023.04.024

合肥市第二人民医院(安徽医科大学附属合肥医院)普外科，合肥 230011

伦理学声明：本例报告已获得患者及患者家属知情同意。

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：李文波负责课题设计，资料分析，撰写论文；张军、鲁俊参与收集数据，修改论文；李良、姜友负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
李文波, liwenbo82@163.com (ORCID: 0000-0002-9516-2998)

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出版历程
- 收稿日期: 2022-07-23
- 录用日期: 2022-08-26
- 出版日期: 2023-04-20

Cholecystoduodenal fistula with gallstone ileus accompanied by colon cancer: A case report

Department of General Surgery, The Second People's Hospital of Hefei & Hefei Hospital Affiliated to Anhui Medical University, Hefei 230011, China

More Information

Corresponding author: LI Wenbo, liwenbo82@163.com (ORCID: 0000-0002-9516-2998)

摘要

- 胆囊疾病 /
- 肠梗阻 /
- 结肠肿瘤
- Gallbladder Diseases /
- Intestinal Obstruction /
- Colonic Neoplasms

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图 1 第1次住院腹部CT

注：a，小肠轻度扩张积气(白色箭头)，未见结肠扩张；b，胆囊壁均匀性增厚，胆囊壁强化后胆囊黏膜大部分完整，胆囊底部模糊与周围肠管分界欠清(白色箭头)；c，盆腔小肠内可见一31 mm×36 mm椭圆形混杂密度灶(白色箭头)，近端小肠肠管扩张积气积液。

Figure 1. Abdominal CT of the first hospitalization

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图 2 取出的肠内结石

注：术中取出一约3.0 cm×3.0 cm×3.5 cm大小褐色质地硬结石，符合胆色素性结石。

Figure 2. Stone removed from the intestine

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图 3 第2次手术前腹部CT

注：a，右半结肠、小肠高度扩张(白色箭头)；b，右半结肠高度扩张，其内可见积气积粪影。

Figure 3. Abdominal CT before the second operation

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图 4 手术标本及术后病理报告

注：a，结肠肝区见一约4 cm×5 cm大小质地硬肿块(白色箭头)，与胆囊致密粘连，分界不清；b，胆囊慢性炎伴胆固醇性息肉形成，镜下炎细胞背景下可见异型上皮细胞(HE染色，×200)；c，结肠浸润性中-低分化腺癌，镜下肿瘤细胞呈密集腺管状结构排列，形态不规则，异型性较多，浸及肠壁全层(HE染色，×200)。

Figure 4. Intraoperative specimens and postoperative pathological diagnosis

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