临床带教与英文查房 | 胶囊内镜确诊黏膜下肿瘤

小白老师说：**Bedside teaching is seen as one of the most important modalities in teaching a variety of skills for the medical profession, which greatly improves certain clinical diagnostic skills in medical students and residents.

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临床带教与英文查房 | 消化科（一）

临床带教与英文查房 | 消化科（二）

In the Demonstration Room

Attending Physician: What is the result of wireless-video-capsule endoscopy?

**主治医师：**无线-视频-胶囊内镜检查结果出来了吗？

Intern: Yes, capsule endoscopy was performed, and the video showed a lesion protruding into the lumen of the distal ileum, with overlying mucosa that appeared normal. A mucosal tumor would have difference in appearance from the surrounding mucosa. Therefore, the most likely diagnoses would be either a submucosal tumor, such as a leiomyoma or lipoma, or an inverted Meckel’s diverticulum.

**实习医生：**出来了。本例病人接受胶囊内镜检查，显示有一病变突起在回肠远端肠腔，被看起来正常的黏膜覆盖。黏膜肿瘤的外观与周围黏膜不同。所以，该突起极有可能为黏膜下肿瘤，如平滑肌瘤或脂肪瘤，或一倒置的 Meckel 憩室。

**Resident：**Using this technique, how confidently can you approximate where the lesion is along the longitudinal axis of the intestine?

**住院医师：**使用这项技术，你有多大把握可确定沿肠纵观轴病变的位置?

**Attending Physician：**I believed that this lesion was in the last third of the ileum because of its proximity to the ileocecal valve, but it is very difficult to judge the location, because the motility of thc small intestine and therefore the transit time are very different from patient to patient.

The physicians reviewing thc study are able 1o divide the bowel into halves or thirds and help thc surgeon identify roughly where thc lesion may be found. The clinical diagnosis of thc patient is submucosal tumor or inverted Meckel’s diverticulum,

**主治医师：**我相信此病变位于回肠后1/3内，因为它接近回盲瓣。但由于小肠的活动性，故瞬变时间因人而异。读片医生能把小肠 2 等分或 3 等分，以协助外科医生大致确定病变位置。该病人的临床诊断是黏膜下肿瘤或倒置 Meckel 憩室。

Resident: Dr. Grey, shall we prepare to give the patient the operation for diagnosis and treatment?

**住院医师：**格雷医生，我们可以准备为病人手术以便确诊和治疗吗?

Intern: Certainly. I will inform the patient with necessary information, including the aim and possible outcome after operation.

**实习医生：**当然可以。我会告知病人必要的信息，包括手术目的和术后可能的结果。