肠梗阻是指各种原因引起的肠道内容物不能顺利通过肠道,是临床中常见疾病,其可分为:机械性肠梗阻、动力性肠梗阻、血运性肠梗阻。在机械性肠梗阻中,除了肿瘤、肠壁扭转、肠道粘连、粪石嵌顿、蛔虫成团等常见病因外,还有一个相对罕见的病因,即发育异常导致本应退化的结构长期存在刺激肠道引发局部炎症及狭窄。脐部肠道索带是由卵黄管发育异常所形成的,其存在可引起肠梗阻等疾病,通过常规检查很难明确病因,多在术中探查时明确。因此结合临床病例探讨其发病机制及诊疗措施对于该疾病的研究有着重大意义。本案报道1例脐部肠道索带引发肠梗阻的病例。现将整个治疗过程阐述如下。Intestinal obstruction refers to the failure of intestinal contents to pass through the intestines for various causes, and is a common disease in the clinic, which can be divided into: mechanical intestinal obstruction, dynamic intestinal obstruction and haemodynamic intestinal obstruction. In mechanical intestinal obstruction, in addition to tumours, intestinal wall torsion, intestinal adhesions, faecal impaction, roundworm formation and other common causes, there is also a relatively rare cause, that is, developmental anomalies lead to long-term presence of degenerative structures that irritate the intestinal tract and cause local inflammation and stenosis. The umbilical intestinal cord is formed by the abnormal development of the vitelline duct, and its presence can cause intestinal obstruction and other diseases. It is difficult to clarify the etiology of the disease through routine examination, and it is mostly clarified during intraoperative exploration. Therefore, exploring its pathogenesis and diagnostic and therapeutic measures in conjunction with clinical cases is of great significance to the study of this disease. This case reports a case of intestinal obstruction caused by umbilical intestinal cord. The whole treatment process
Ⅳa期胃癌属于局部晚期胃癌(locally advanced gastric cancer,LAGC),中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)指南推荐行多学科联合会诊(multidisciplinary consultation,MDT)讨论制订个体化治疗方案。近年来,随着精准医疗观念的不断加深,国内外越来越多的专家及学者逐渐重视新辅助治疗。新辅助治疗是指:对于初始评估手术指征存在但是病变局部已经处于晚期的恶性肿瘤患者,手术治疗难度大或需要联合脏器切除,可行新辅助治疗以减小肿瘤及转移灶、增加肿瘤完全切除(R0)率,同时进一步降低术后远处转移和肿瘤的复发率。本例患者临床分期为cT4bN3aM0、Ⅳa期,经过2周期新辅助治疗后,患者肿瘤病灶完全消失,现将其临床表现、影像学结果、病理学结果及治疗过程阐述如下,并结合相关文献分析,为该类疾病的诊治提供参考。
