症狀:
右上腹有壓迫感、異物感,伴隨灼熱感,好像裡面長了什麼東西,坐下來感覺十分明
顯,坐久了會以灼熱感為主.站起來則較沒感覺,平躺著會有感覺,往左側躺,會有異物
感,往右側躺則消失,平常都往右側躺睡覺.
平時以壓迫感、異物感為主,發作時,會有灼熱感和疼痛,通常在吃完東西或熬夜(有時
工作到早上8點睡)症狀持續24小時,約4年以上.
先前經醫師診斷原本認定為膽結石造成,超音波確診膽結石,開完刀後症狀卻沒有改善.
在手術之前,去年10/4日驗血曾經有肝指數AST升上914 ALT 605的
情形,目前手術完畢.
今年進一步檢查,做了ct和大腸鋇劑x光攝影,也照了胃鏡,檢查出兩個病,胃黏膜下
腫瘤(大約兩顆,一公分左右)以及大腸憩室炎,醫生排除胃黏膜下腫瘤為造成右上腹的
原因,認為可能是大腸憩室炎造成.
他認為大腸憩室炎不到要開刀的程度,只能吃藥控制.x光片上他說有多個憩室,但看不
清楚共有幾個,也不知道是不是集中在右上腹,只說在升結腸、橫結腸、降結腸處都有.
我想問的是,
1. 大腸憩室炎會造成持續4年,幾乎整天坐著都有的壓迫感嗎?
2. 胃黏膜下腫瘤如果是惡性,會是右上腹的症狀嗎?
3. 如懷疑是肝的問題,去照肝纖維掃描是否能看的出來?
4. 要不要做大腸鏡,看清楚右上腹的位置,是不是憩室炎確診.
感謝!這個病真的困擾我很久...更慘的是當初以為開了膽結石的刀就會好,結果還是
存在.
附上病歷表和x光片:
胃黏膜下腫瘤部分
Esophagus: There was no ulcer nor varix in the esophagus.
Stomach: A polyp about 0.2 cm was found at fundus.Biopsy was done. A big
submucosal tumor was found beside it.
Duodenum:No bulb deformity nor ulcer was found.A big submucosal tumor was
found in the 2nd portion,too.
Diagnosis:Gastric polyp,fundus,s/p biopsy.
Gastric submucosal tumor,fundus.
Duodenal subvmucosal tumor,2nd portion.
大腸憩室炎部分
smooth passage of contrast medium through the rectum and colon to terminal
ileum.
normal presacral space.
normal caliber and contour of the colon without focal luminal narrowing.
Multipe small outpouchings at ascending,transverse,and descending colon.
normal contour of the colon mucosa in post-evacuation film.
x光片:
https://imgur.com/wBt3nG8
https://imgur.com/e0yBoxJ
https://imgur.com/vhRDOUO
https://imgur.com/NqhkJ0U
https://imgur.com/4RhqYrX
https://imgur.com/3jCNfto
https://imgur.com/0cQU8Ad
https://imgur.com/vCR7qJv
https://imgur.com/WBGcfG5
https://imgur.com/tF6yctQ
https://imgur.com/ODgkyDn
https://imgur.com/RSTBsXE
https://imgur.com/LTxGxcT
https://imgur.com/EpjsnIs
https://imgur.com/Bs4OueN