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Casereport TheThirdWardofTheDepartmentofGastroenterology TheThirdSectionofTheDepartmentofGastroenterology MedicalRecordsforAdmissonMedicalNumber Y1571532Generalinformation Name XXXAge TwentyOneSex MaleRace HanNationality ChinaAddress XinYang Henan Occupation Excavatordriver Maritalstatus UnmarriedDateofadmission Nov11th 2015Dateofrecord 8Pm Nov11th 2015Complainerofhistory patient sfatherandhimselfReliability Reliable Chiefcomplaint Reduplicatednauseaandvomitforsixandahalfmonths TheThirdSectionofTheDepartmentofGastroenterology Presentillness Thepatientfeltsuddennauseaandvomitedthefoodhetookinwithnorecognizablecauseaboutsixandahalfmonthsago Hedidn tpayattentiontoitandthoughthehadatesomethingwrong TheThirdSectionofTheDepartmentofGastroenterology Presentillness Abouttwoweekslater thenauseousandvomitorysymptomappearedagainandhefeltsourregurgitationandheartburnatthesametime SohewenttothefirstaffiliatedhospitalofSuZhouUniversity TheThirdSectionofTheDepartmentofGastroenterology Presentillness Theendoscopicexaminationshowedhehadduodenalulcersandrefluxesophagitis Andthepathologicalreportoftheulcerswaschronicinflammationwithproliferationoflymphocytes ThentheRabeprazolewhichhadshowacurativeeffectwasgiventohim TheThirdSectionofTheDepartmentofGastroenterology Presentillness Buttwomonthslaterafterthetreatment theabove mentionedsymptomappearedagainandbecamemoreserioussohewenttothefirstaffiliatedhospitalofSuZhouUniversityagainforfurtherthreatment TheThirdSectionofTheDepartmentofGastroenterology Presentillness TheabdominalCT MRIandMRCPallshowedthedilatationofthebileducts boththeintra hepaticandextrahepaticbiled ucts andthepancreaticducts Besides theabdominalCTsho wedtheenlargementofpancre aswiththeprobabilityofpancr eaticdivisum Thenhewasdiag nosedaspancreatitisandthesymptomatictreatmentwasappliedbuttheeffectwasnotcomfor table TheThirdSectionofTheDepartmentofGastroenterology Presentillness SohewenttothefirstaffiliatedhospitalofZhengZhouUniversity TheabdominalCTshowedtherewereso meenlargedlymphnodesintheabdominalcavityandtheduodenalwallhadbecamethickened Thepathologicalex aminationreportoftheduodenalwallshowedhewasdia gnosedTlymphoma TheThirdSectionofTheDepartmentofGastroenterology Presentillness Foraccuratediagnosis hisfamilysentthepathologicalslidetothreetophospitalsofChinainBeijing NetherthepathologydepartmentofourhospitalnortheYouyihospitalcouldexcludethediagnosisoftheTlymphoma butthepathologydepartmentofthehospitaloftheBeijingUniv ersityhaddiagnosedthathewasnotapatientwithTly mphoma TheThirdSectionofTheDepartmentofGastroenterology Presentillness Onemonthagohewenttotheemergencydepartmentofourhospitalfortreatment Thepathologicalexaminationoftheduodenalwallshowedth erewassevereacuteinflame mationwiththeinfiltrationofmanyeosnophils Theintesti nalfeedingtubewasappliedbutfilled TheThirdSectionofTheDepartmentofGastroenterology Presentillness Eightdaysago thepatientwasacceptedbecauseof reduplicatednauseaandvomitforsixandahalfmonths Sincethediseasecomingon thepatienthadlosed18kgweights TheThirdSectionofTheDepartmentofGastroenterology Pasthistory Thepatientishealthybefore Nohistoryofinfectivediseases Noallergyhistoryoffoodordrugs TheThirdSectionofTheDepartmentofGastroenterology Impression Unexplainedstenosisoftheduodenum CrohnDiseaseoftheduodenum Tlymphomaoftheduodenum Tuberculosisoftheduodenum Behcetdisease Nonspecificinflammation Malignanttumor TheThirdSectionofTheDepartmentofGastroenterology Pasthistory Operativehistory Neverundergoinganyoperation Infectioushistory Nohistoryofsevereinfectiousdisease Allergichistory Hewasnotallergictopenicillinorsulfamide Respiratorysystem Nohistoryofrespiratorydisease Circulatorysystem Nohistoryofprecordialpain Alimentarysystem Nohistoryofregurgitation Genitourinarysystem Nohistoryofgenito

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