Cover tumour among the peritoneum (digest department of internal medicine)
Summary
Cover tumour refers to sending at tumour of skin cells among the peritoneum originally among the peritoneum. Clinical manifestation does not have characteristic nature, common symptom and physical sign are as follows, abdominal pain, ascites, abdominal distension and belly wrap up one etc.. Peritoneum leather tumour account for all leather tumour 20 of case, can take place on 2 - 92 year old, mean age is 54 year old, invite case of 63 between 45-64 year old, children getting ill and rare among them.
Clinical manifestation
1.Abdominal pain, abdominal distension, ascites, belly wrap up lumps; 2.Apocleisis, disgusting, vomits, the diarrhoea, constipation; 3.Weak, generate heat, become thin, anaemia; 4.Hypoglycemia, filling the air belly ossify; 5.Amalgamate other leather tumour such as leather tumour under peritoneum under position, shift other internal organs and corresponding behavior to amalgamate disease.
Diagnose the basis
1.The patient whose abdominal pain, abdominal distension, ascites, belly wrap up the lump, especially there is asbestos that contacts the history; 2.The image learns to check the peritoneum and have laminar tumour sign and ascites; 3.The ascites comes off cytology is checked; 4.Peritoneum live examine, peritoneoscope and cut open belly ascertain and fetch, organize, make pathology can be made a definite diagnosis of while checking.
Treat the principle
1.Surgery treatment; 2.Radiotherapy; 3.Chemotherapy; 4.Support and treat to the ill.
Use medicine principle
1.Jointly use medicine ' Such as obeying platinum + Ring phosphorus amide + New alkali in Changchun) ,Cooperate the injection chemotherapy medicine in the abdominal cavity ' Such as obeying platinum) ; 2.Injection 32 P or colloidal gold, radiotherapy in abdominal cavity and uniting the chemotherapy medicine; 3.The case that can't excise to the operation, adopt the radiotherapy (60 C o) With chemotherapy ' Ring phosphorus amide, Changchun new alkali, dactinomycin D,etc.) .
Auxiliary examination
1.Check the frame limit " A " Disease apt to obscure except facilitating; 2.Check the frame limit " B " Facilitate making a definite diagnosis of.
Curative effect is appraised
1.Cure: Tumour is excised, without complication, the notch heals, clinical symptom disappears; 2.Take a favorable turn: Symptom is improved after radiotherapy, chemotherapy, tumour dwindles or the growth speed is slowed down, the appetite takes a favorable turn, the weight increases; 3.Have not healed: The physical sign of clinical symptom does not disappear.
The expert briefs on
It is leather for tumour in peritoneum skin at being the of originating from peritoneum with among whether skin organize,asbestos the dusts is for materials pathogenic, some virus may be the reason for causing a cover tumour too. The cover tumour pathology among the peritoneum can be divided into: Adenoma kinds of tumour, leather tumour, and leather tumour 3 among being malignant among the bag. Peritoneum leather tumour clinical manifestation have specificity is relevant to check masculine gender lead high, the specificity is not strong, clinical diagnosis is very difficult. As the peritoneoscope is checked, supersonic wave and C T lead living puncture to examine the development, pathology, immunity of technology to organize chemistry and electric mirror to diagnose the improvement of competence, more and more cases get clear pathological diagnosis before death or before the skill. Leather tumour answers mainly among the peritoneum and tuberculosis peritonitis, shift cancer, other tumours that take place in the abdominal cavity in the big omentum of peritoneum originally to distinguish. Up until now, peritoneum leather tumour lack specific therapeutic method still, most scholar maintain, include surgery excise, postoperative radiotherapy with chemotherapy comprehensive to treat the measure.