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胆总管下端绒毛状腺瘤伴癌变一例报告 预览

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摘要 患者,男性,67岁。因突发上腹部疼痛12h于2002年7月7日入院。腹痛呈持续性剧烈疼痛,无放射,伴皮肤轻度黄染,无发热,恶心未呕吐。查体:体温36.0℃,皮肤巩膜轻度黄染。腹平坦,未见肠型及蠕动波、无腹壁静脉曲张。中上腹压痛明显,无明显肌紧张。肝脾未触及,无包块。腹部叩呈鼓音,移动性浊音阴性,肠鸣音稍弱。B超:胆囊增大来探及结石影,胆总管增宽1.0cm。CT:胰腺增大,胆囊增大。化验:血白细胞16.5×10^9/L,中性粒细胞90%;尿常规尿胆原(++);血淀粉酶1300u/L,尿淀粉酶8879u/L;天冬氨酸转移酶155u/L,总胆红素40.3mmol/L。MRCP:肝内外胆管、胆总管明显扩张,胆总管末端狭窄似残根状,其周末见明显软组织影。初步诊断为;急性胰腺炎;急性胆囊炎;梗阻性黄疸。
出处 《内蒙古医学杂志》 2006年第1期 94,共1页 Inner Mongolia Medical Journal
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