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在传染病房,经常可以发现一些误诊为病毒性肝炎的其他系统疾病或其他原因引起的肝损伤,或因黄疸住院,或因肝硬变住院。现将部分病例作一介绍,供同道参考。 1 先天性胆总管囊肿【例1】女,3岁2个月。因腹痛,黄疸21天住院。患儿于入院前3周出现腹痛,为阵发性,位于上腹部,但可忍耐,同时发现尿黄、皮肤黄染。近一周来发热,体温在38℃左右,伴有进食差,乏力。病后无呕吐、腹泻等症状。病后在其他医院按“黄疽型肝炎”治疗,因病情无好转,近一周来黄疸加重而来我院。门诊化验尿胆红素及尿胆原均为阳性,以“传染性肝炎”收入病房。患儿既往生长发育正常,健康状况良好,无其他重病史,家族成员中无传染性肝炎患者。体格检查营养发育中等,精神差,易烦躁,皮肤及巩膜明显黄染,咽轻度充血,肺呼吸音清,心音有力,心律
In infectious wards, some other systemic diseases that are misdiagnosed as viral hepatitis, liver damage caused by other causes, hospitalization for jaundice, or hospitalizations for cirrhosis can often be found. Now some cases for an introduction for fellow reference. 1 congenital choledochal cyst [Example 1] Female, 3 years old and 2 months. Due to abdominal pain, jaundice 21 days hospitalization. Children with abdominal pain 3 weeks before admission, paroxysmal, located in the upper abdomen, but can endure, and found that urine yellow, yellow skin. Nearly a week to fever, body temperature around 38 ℃, accompanied by eating poor, fatigue. After the illness no vomiting, diarrhea and other symptoms. In other hospitals after the disease by “jaundice hepatitis” treatment, due to the condition did not improve, nearly a week jaundice increased from our hospital. Urine bilirubin and urine samples were clinically positive urine tests to “infectious hepatitis” income ward. Children with normal growth and development in the past, good health, no other history of serious illness, family members without infectious hepatitis patients. Physical examination Physical development of moderate, poor spirit, easy irritability, the skin and sclera significantly yellow dye, mild congestion of the pharynx, lung breath sound clear, strong heart sounds, heart rhythm