The 37-year-old woman was twice diagnosed with "bowel cancer" but could not find tumor cells! The ending is a peak loop...

The condition of the 37-year-old young woman was extended for 2 years, abdominal pain, lumps, stool blood, high intestinal cavity stenosis, tumor markers increased ... Two hospitalizations are considered "bowel cancer", but two gastroscopic biopsies did not reach the tumor cells, the final truth was revealed, so that she was "happy", and "surprised"! Two hospitalizations to consider "bowel cancer", the pathology can not find tumor cells live in Nanchang, Ms. Liu (adrotic name) 37 years old, 2 years ago she suddenly appeared unexplained left lower abdomen intermittent cryptic pain, before detox not only pain intensified, left lower abdomen can also touch the bag, but after the constipation with pain relief, the bag can not touch, to say that constipated feces, stool is often not formed.
thought that since she could ease herself, she didn't think it was a big illness, she didn't care too much.
, however, the disease is quietly progressing.
6 months ago, Ms. Liu suddenly began to appear intermittent blood, this time, she was really afraid, rushed to the hospital to check.
to the hospital to check, there is something really wrong! Tumor marker CA125 elevated not to say, colonoscopy suggests that the B colon is obviously narrow, the endoscope has been unable to pass, highly suspected of B colon cancer.
the word "cancer" on the report is like a thunderbolt.
you get bowel cancer when you're young? Ms. Liu really want to cry without tears, let her depressed is that the biopsy pathology of the colonoscopy did not find tumor cells, white suffered a sin.
is it false negative, the biopsy did not get tumor tissue? After a period of time, Ms. Liu went to the doctor again, and did a colonoscopy, but unfortunately the biopsy still did not find tumor cells, still highly suspicious of B colon cancer.
peak circuit, the truth in the image test results revealed the "tail" height suspicious and undiagnosed, can not be diagnosed can not be treated, but the colon has narrowed to this extent, the disease can no longer be delayed.
this feeling of fear is too uncomfortable, the family to consult a referral to Shanghai.
this referral really found a problem.
in a difficult case discussion, doctors noticed a significant difference between Ms. Liu's two abdominal CTTs, which were only 20 days apart.
May 22 colon helical CT examination showed that the colon wall of B-shaped colon swelling, thickening, but only 20 days later, the swollen B-shaped colon wall appeared on the limitations of significant thickening, and can be seen 1.5 cm x 2.0 cm substantial nocculosis, enhance the scan after uniform moderate reinforcement, prompting dynamic changes.
We all know that tumors typically multiply for at least 40 days, and that the noseds are never possible in 20 days, and grow into a substantial apricot-sized nod, and the likelihood of colon tumors decreases rapidly.
, what is a colon tumor? Careful doctors learned that the second CT examination, Ms. Liu is in the menstrual period, why this lesions change and menstrual cycle related? Combined with ms. Liu 2 years ago has the left attachment cyst minimally invasive surgery of the treatment history, so highly suspicious of endometriosis, taking into account the patient's intestinal stenosis is obvious, it is recommended to perform laparoscopic examination to clearly diagnose.
the end, Ms. Liu under the laparoscopic examination on June 19th, see the ring-shaped narrow lesions at the junction of the colon and the B colon, to the narrow lesions local intestinal section excision, after surgery to remove the intestinal tube sent pathology examination See a diameter of 3.5 cm x 3.0 cm and occupy 3/4 tube cavity stiff area, pathologically shown (B colon) endometriosis, infringing the colon plasma membrane layer to the lower mucous membrane.
this point, this case in the hospital 2 visits are intended to diagnose colon cancer cases finally sealed the conclusion.
what? Terrified half-dead, not a tumor? What the? Abdominal pain, stool blood because the endometrium grows on the intestines? Successive information made Ms. Liu "happy" and "surprised"... What is endometriosis? As the name implies, endometriosis is the endometriosis that should have grown in the uterine cavity in places that should not be long, such as the surface of the ovaries, the surface of the pelvic peritina, the rectum, the bladder, and even the lungs, meninges, heart bags, nasal cavity, etc.
even more surprising is that the endometrial tissue that "flows" to other parts responds to the hormone's signals, as normal endometrial tissue does, periodically peeling off bleeding like menstruation.
In this, often patients due to unexplained nosebleeds, hemorrhage, stool blood, urine blood, etc. , was mistaken for a tumor, frightened, and finally found that bleeding symptoms and menstrual cycle, is endometriosis.
and most of the heterosis, "through blood" and the outside world, can not be discharged, is "closed" in the body, resulting in severe pain, nodding, fibrosis, and even infertility and other clinical symptoms.
endometriosis seriously affects women's health and quality of life, and the lesions are extensive, diverse in form, very aggressive and recurring, is difficult to treat.
clinically described as a benign disease with the biological properties of malignant tumors.
However, most people have not heard of the disease is a common gynaecological disease, multiple morbidity, 10% to 15% of women of childbearing age will appear in their lifetime, of which 76% of the incidence in 25 to 45 years old, less fertility, late birth of women significantly higher incidence than more fertility, early birth.
years, the incidence of endometriosis has been increasing, known as "modern disease."
can I catch the traces and find endometriosis? In general, women of childbearing age have the following 5 symptoms, need to be alert to the presence of endometriosis.
more than half of patients with endometriosis experience pain, and sexual pain is considered a typical symptom of endosis.
pain is often located in the lower abdomen and lower back, can be radiation to the vagina, vaginal, anus or thighs, often 1 to 2 days before menstrual, menstrual tide when the most intense, to menstrual clean disappear.
02 Infertility endometriosis patients in the infertility rate as high as 40%, the literature reported that in the infertility patients in the laparoscopy, found that about 44.7% of patients combined with endometriosis.
causes infertility are mainly four.
1, medium and severe patients because of ovaries, fallopian tubes around the adhesion affected the transport of fertilized eggs; 2, abdominal cavity microenvironment changes, affecting sperm egg binding; 3, abnormal ovary function, about 17%-27% of patients with ovulation disorders, 25%-45% of patients with yellow body function is insufficient;
03 sexual intercourse pain has about 30% of patients have sexual intercourse pain, due to heterogeneous lesions so that the tissue around the reproductive organs hematoma swelling, fibrosis adhesion, collision during sexual intercourse on the uterine contraction and pain, most often seen in the lesions tired and vaginal rectum shin or due to lesions caused by the uterine reclining fixed, generally manifested as deep sexual pain, menstrual pre-tidal sexual pain is more obvious.
04 menstrual abnormality of about 15%-30% of patients with increased menstruation, prolonged menstruation, menstruation insulating or pre-mesothropic bleeding, with the ovaries are physically affected, no ovulation, yellow body function is not enough.
05 other special symptoms of other symptoms are different from the site of cultivation.
Intra-abdominal wall indentation and intra-intra-intra-insulation after delivery for patients undergoing caesarean section or vaginal delivery lateral instomation surgery, endometrial tissue with amniotic water planted at the surgical indentation, often in caesarean section or will be clitoris after several years to several years of periodic scar pain.
intraintestinal disorders can lead to intestinal stenosis, can cause pre- and menstrual constipation, difficulty detox, detox pain and acute post-intestinal feelings, and after menstruation symptoms ease, and even some patients can appear diarrhea symptoms.
such as lesions and intestinal trachea deep into the mucous membrane layer, can cause periodic blood stools.
bladder or intratrauterine disorders, can appear urinary system-related symptoms, such as urinary frequency, urinary pain, periodic blood urine, lumbar acid, etc. ;
ovarian cysts, which can form ovarian endometrial cysts.
During menstruation, ovarian endometrial-like cysts can suffer from multiple small ruptures due to bleeding and increased stress, which are wrapped in surrounding tissue and cause excessive pain in the lower abdomen or deep pelvic cavity.
if the larger ovarian endometrial-like cyst appears to have a relatively large rupture, it can also cause sudden severe abdominal pain, often accompanied by nausea, vomiting and swelling.
The best way to diagnose endopathy is laparoscopy, especially in patients with infertility or abdominal pain who have not been positive for pelvic and B ultra-tests, and can be diagnosed with live tissue examination of typical lesions or suspicious lesions under laparoscopy.
only under laparoscopic direct vision can we accurately determine the clinical stage of internal heterosis.
the vast majority of patients with mild endometriosis are diagnosed through laparoscopy.
I watch out for endometriosis, although this case the patient ruled out colon tumors and endometriosis has been cured, but we need to realize that endometriosis is by no means the place where the bleeding is the risk of blood, endometriosis also has a risk of evil."
According to the statistical analysis of clinical cases, the evil rate of ovarian cysts is 0.7% to 5%, the degree of evil change is high, poor prognosis, we should pay attention to the importance of regular examination, early detection, early treatment, so as not to delay the disease. The majority of
endotrophic changes occur in the ovaries, that is, ovarian cancer related to internal heterosis, accounting for more than 80%, a few of the cancers associated with ovarian heterosis, less than 20%, the affected areas are: intestines, pelvic cavity, vaginal rectum isolation, vaginal, or even caesarean scars, or vulverts and vaginal inclements.
should be alert to the possibility of erration in the following 7 clinical manifestations.
(1) long medical history, 10 to 15 years; (2) age greater than 45 years old; (3) ovarian cysts are too large, more than 10 cm in diameter, or there is a clear increase in trend; (4) diagnosed with menopathy; (5) extincens After relapse, pain rhythm changes, pain progression or continuous painless; (6) serum CA12 200 kU/L; (7) imaging examination found substantial or nipple-like nosedomy or lesions in the ovarian cyst, blood flow rich.
can we prevent endometriosis? Finally, the editor-in-chief knows that everyone must care about this.
how to prevent also has to look at the cause of the disease.
However, the mechanism of the development of internal heterosis has not yet been determined, the most classic is the theory of "transverse blood flow", that is, when menstruation, a part of the blood flow back to the pelvic cavity through the fallopian tubes, if the inner membrane tissue is planted in the periary membrane of the pelvic cavity, and rooted will form endometriosis.
addition, there is the body cavity epithelial birth into the endometrium, endometrial through the blood, lymphatic system of benign transfer, caesarean section and scraping caused by medical endometrial transplantation, as well as immune, genetic and other factors.
this, prevention is still very difficult.
you see, genetics, immune factors and so on, are not preventable.
the prevention method, only to reduce blood transverse flow, prevent endometrial planting, inhibit ovulation.
for reducing menstrual reflow, to avoid menstrual sex, there are reproductive tract latching, transverse, narrow, adhesion and other obstacles to blood discharge, to be dealt with as soon as possible.
for the prevention of endometrial implantation to avoid human flow and other urinal surgery, pre- and menstrual do not do urinal cavity, cervix, vaginal surgery.
, the use of oral contraceptives can inhibit ovulation and reduce the risk of onset.
, again, to the age suitable for childbirth, get pregnant and have children! China Medical Tribune comprehensively compiled from the Chinese Digestive Journal, China Journal of Practical Gynecology and Obstetrics, China Obstetrics and Gynecology Infection Network, Sun Yat-sen University affiliated with the Six Hospital Reproductive Center and other Chinese medical tribune Source: China Medical Tribune Copyright Notice: All noted on this website "Source: Metz Medicine Or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine."
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