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首页> 外文期刊>Journal of Medical Case Reports >Malignant peritoneal mesothelioma presenting as recurrent adhesion obstruction in general surgery: a case report
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Malignant peritoneal mesothelioma presenting as recurrent adhesion obstruction in general surgery: a case report

机译：恶性腹膜间皮瘤在一般外科手术中表现为复发性粘连阻塞：一例报告

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Introduction Malignant peritoneal mesothelioma is a well-described entity in many reports in the literature in which it has been associated with asbestosis. However, there is no information describing the gross appearance and cardinal features seen during laparotomy, hence it is easy for the unwary surgeon to miss the diagnosis of this rare condition. Case presentation A 49-year-old man of African descent presented to our hospital with a three-month history of weight loss, anorexia, abdominal distension, and general signs of cachexia and ascites on second presentation. At first presentation one year prior to this, he had undergone a laparotomy at our institution by a different team for intestinal obstruction secondary to adhesions with no biopsy taken. The patient's condition subsequently progressively deteriorated, and investigations including upper and lower gastrointestinal endoscopies and computed tomography of the abdomen were inconclusive, except for some free fluid in the peritoneal cavity and diffuse, mild thickening of the gut wall and mesentery. A second-look exploratory laparotomy revealed widespread nodular thickening of the visceral peritoneum with a striking, uniformly diffuse, erythematous, and velvety appearance. The peritoneal biopsy histology showed that the patient had malignant peritoneal mesothelioma. His condition deteriorated rapidly, and he died eight weeks after surgery. Conclusion Our report aims to increase the diagnosing clinician's awareness of the cardinal features of malignant peritoneal mesothelioma and thus reduce diagnostic errors and delays in treatment.
机译：引言恶性腹膜间皮瘤是文献中许多与石棉病相关的报道中被充分描述的实体。但是，由于没有信息描述剖腹手术时所见的总体外观和主要特征，因此，粗心的外科医生很容易错过这种罕见病的诊断。病例介绍一名49岁非洲人后裔在我院就诊，有3个月的体重减轻，厌食，腹胀以及恶病质和腹水的一般症状。在此之前一年的第一次演讲中，他曾由我们的另一支团队在我院接受剖腹手术，该手术是由于粘连继发的肠梗阻，没有进行活检。患者的病情随后逐渐恶化，除了腹膜腔内有一些游离液体以及肠壁弥散性，肠壁轻度增厚和肠系膜外，包括上，下消化道内镜检查和腹部CT成像在内的检查尚无定论。二次探查性剖腹术显示内脏腹膜广泛结节性增厚，外观醒目，均匀扩散，红斑和天鹅绒般。腹膜活检组织学检查表明该患者患有恶性腹膜间皮瘤。他的病情迅速恶化，在手术后八周死亡。结论我们的报告旨在提高诊断医生对恶性腹膜间皮瘤基本特征的认识，从而减少诊断错误和延迟治疗。

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