消化系統(tǒng)疾病-30胃腸道中英文7b校case lucy unterer

Clinical Bergerde12years12Historywaterydiarrheasince2weeks水樣腹瀉2isnoteatingwellpre-treatmentwithdexamethasone,antibiotics,ranitidine,metamizole1weekago 1yearagosurgerytoremovemammaryphysicalexaminationmucousmembranespinkdrycardiacauscultationmuffledheartsoundsabdominalpalpationtense,painfulmassintherightcaudalmammarycomplex(notcircumscribable,（無(wú)法定界限，質(zhì)地軟waterydiarrheaduringphysicalexamreferenceredbloodx5.5-7.45-0.35- x150-x5--x0.04--x1--bandx0--seg.x3--0x0--0x0-單參考范x5.5-7.45-0.35-x150-x5-x0.04-x1-x0-x3-0x0-0x0-reference0-0-0-ALP00-0-2280-0-0-0-0-酶0-0-0-ALP00-0-2280-0-0-0-0-reference0-0-0-3.1-0.27-total48-25-3.3-32-3.33-0-0-0-0-3.1-0.27-48-25-3.3-32-3.33-0-referenceP0.71-99-143-K3.9-2.4-11-0.7-P0.71-99-143-K3.9-2.4-11-0.7-blood.7.34-36-pO285-19---2.5-7.34-36-pO2動(dòng)脈85-19---2.5-coag.referenceQuicktest0-PT0-0-0-TEG1.9-TEG1.6-TEG41-bleeding60-antithrombin%95-0-D-<0-Quicktest0-PT0-0-0-TEG1.9-TEG1.6-TEG41-60-抗凝血酶%95-0-D二聚<0-reference----5.5-----------------+-spec.1.015-RBC2-尿參考范尿亞硝酸---5.5-蛋白--葡萄------尿膽--膽紅--+-尿1.015-RBC2-furtherexamination腹部超furtherexamination腹部超furtherexaminationabdominalultrasound腹部超granulatedliver肝臟顆粒樣回furtherexaminationthoracicultrasound胸腔超furtherexaminationthoracicradiographs胸腔Xsmallamountofthoraciceffusion少量胸furtherexaminationabdominalradiographs腹部Xlossofdetail細(xì)節(jié)丟thoracicspecificxx單xxysisaspiratespecificxx單xxfurtherexaminationEndoscopy內(nèi)窺furtherexaminationEndoscopy內(nèi)窺furtherexaminationendoscopy內(nèi)窺smallamountofgreen-yellowfluidwithfattydroplets(sunfloweroil)duodenum,十二指腸，空腸pale,fragilemucosawithwhitestipples粘膜蒼白，質(zhì)地較脆，有白色的斑furtherexaminationsHistology組織stomach:intestines:diffusemarkeddilationoflymphoidvessels,moderatelymphocytic/plasmacyticinflammationfurtherexaminationsfurtherexaminationslymphocytic淋巴細(xì)胞性plasmacytic漿細(xì)胞性furtherexaminationsHistology組織furtherexaminationsHistology組織markedlydilatedvillusatrophyvillusatrophydilatationofTreatment治peripheralparenteralnutritionintravenouscolloids靜脈內(nèi)輸入膠體液（羥乙基淀粉 cyclosporin環(huán)孢菌antibi