消化系统疾病-30胃肠道中英文7b校case lucy unterer

Clinical Bergerde12years12Historywaterydiarrheasince2weeks水样腹泻2isnoteatingwellpre-treatmentwithdexamethasone,antibiotics,ranitidine,metamizole1weekago 1yearagosurgerytoremovemammaryphysicalexaminationmucousmembranespinkdrycardiacauscultationmuffledheartsoundsabdominalpalpationtense,painfulmassintherightcaudalmammarycomplex(notcircumscribable,（无法定界限，质地软waterydiarrheaduringphysicalexamreferenceredbloodx5.5-7.45-0.35- x150-x5--x0.04--x1--bandx0--seg.x3--0x0--0x0-单参考范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动脉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-尿参考范尿亚硝酸---5.5-蛋白--葡萄------尿胆--胆红--+-尿1.015-RBC2-furtherexamination腹部超furtherexamination腹部超furtherexaminationabdominalultrasound腹部超granulatedliver肝脏颗粒样回furtherexaminationthoracicultrasound胸腔超furtherexaminationthoracicradiographs胸腔Xsmallamountofthoraciceffusion少量胸furtherexaminationabdominalradiographs腹部Xlossofdetail细节丢thoracicspecificxx单xxysisaspiratespecificxx单xxfurtherexaminationEndoscopy内窥furtherexaminationEndoscopy内窥furtherexaminationendoscopy内窥smallamountofgreen-yellowfluidwithfattydroplets(sunfloweroil)duodenum,十二指肠，空肠pale,fragilemucosawithwhitestipples粘膜苍白，质地较脆，有白色的斑furtherexaminationsHistology组织stomach:intestines:diffusemarkeddilationoflymphoidvessels,moderatelymphocytic/plasmacyticinflammationfurtherexaminationsfurtherexaminationslymphocytic淋巴细胞性plasmacytic浆细胞性furtherexaminationsHistology组织furtherexaminationsHistology组织markedlydilatedvillusatrophyvillusatrophydilatationofTreatment治peripheralparenteralnutritionintravenouscolloids静脉内输入胶体液（羟乙基淀粉 cyclosporin环孢菌antibi