2022年 · 第60卷第08期

A 71-year-old male was admitted to the hospital on 21-Jun-2021 due to "upper abdominal discomfort for 2 months, aggravated for 3 days". The patient had repeated mild pain in the upper abdomen for 3 months, which improved after taking analgesics on his own. One month before admission, gastroscopy showed congestion and erosion of the mucosa of the gastric body. An irregular ulcer of about 3.2 cm ×2.2 cm in size was seen near the posterior wall of the large curve of the lower segment of the gastric body, with unclear boundary and interrupted mucosal folds. The pathological examination of biopsy showed ulcerative poorly differentiated adenocarcinoma of the lower segment of the gastric body. Income "gastric cancer" into abdominal tumor surgery for further treatment. The patient had no history of hypertension, diabetes, trauma and surgery, did not smoke, occasionally drank alcohol, and had no family history of tumor. The diet was reduced by 50% in 1 month and the body weight was reduced by 5 kg. Admission physical examination: height 165 cm, weight 50 kg, body mass index 18.4 kg/m²。 There was no yellowing stain in the skin sclera, no swelling in the abdomen, no tenderness, rebound pain, no mass, and normal intestinal sounds. The liver and kidney function and electrolytes were normal, with total protein 59.92 g/L, albumin 32.20 g/L and prealbumin 155.32 mg/L. All tumor markers were normal. After admission, the examination was completed, and one week later, laparoscopic radical gastrectomy was planned.

The patient, a 48-year-old male, was admitted to our hospital on October 27, 2021 due to "varicose veins in both lower limbs for 6 years". Six years ago, the patient developed varicose veins of both lower limbs, accompanied by soreness and edema of the lower limbs, which were aggravated after exertion and relieved after rest. Three years ago, the patient underwent "high ligation and stripping of the left great saphenous vein" in an external hospital to treat varicose veins of the left lower limb. Physical examination on admission: The patient developed normally, had a slender body, no varicose veins in the chest and abdomen wall, no varicocele, negative percussion pain in bilateral kidney area, varicose veins in both lower limbs, mild pigmentation in the skin of the foot boot area of the right lower limb, mild edema in the right lower limb, scar of surgical incision in the left lower limb, and the leg circumference of the ankle, calf and thigh of the right lower limb was 21 cm, 35 cm and 52 cm, respectively, and the leg circumference of the ankle, calf and thigh of the left lower limb was 21 cm, 33 cm and 51 cm, respectively, and the Track's test of the right lower limb was positive. Laboratory test: Red blood cell count 4.08×10¹²/L, hemoglobin 130 g/L, albumin 40.2 g/L, urea nitrogen 6.9 mmol/L, serum creatinine 88.2 μ mol/L, uric acid 343.15 μ mol/L, urine occult blood (+ + +), urine red blood cells 3 125/μ L, urine microalbumin 0.15 g/L. Venography of the right lower extremity revealed left inferior vena cava malformation and right iliac vein compression syndrome (Figure 1A). CT angiography of the aorta showed that the left inferior vena cava was malformed and the right iliac vein was compressed and narrowed (Figures 1B-1D).