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病例资料患者,男,65岁,因“反复上腹部疼痛10个月余,伴皮肤巩膜黄染15 d”入院。患者既往有二尖瓣置换术病史。查体:皮肤巩膜重度黄染,浅表淋巴结未触及肿大,全腹散在压痛,无反跳痛、肌紧张,Murphy征阳性。B超检查示:结石性胆囊炎并萎缩、胆总管扩张。上腹部增强CT检查(图1)示:胆总管中上段管壁增厚,胆管高位梗阻,胆囊壁不均匀增厚。实验室检查示:CA-125 151 U/m L,甲
Case data patients, male, 65 years old, because of “repeated upper abdominal pain for more than 10 months, with scleral yellow dye 15 d ” admission. The patient had a history of mitral valve replacement. Physical examination: Sclera severe yellowish skin, superficial lymph nodes did not touch the enlargement, the whole belly scattered tenderness, no rebound tenderness, muscle tension, Murphy sign positive. B-ultrasound showed: stone cholecystitis and atrophy, common bile duct dilatation. Upper abdominal enhanced CT examination (Figure 1) shows: the upper bile duct wall thickening, high bile duct obstruction, gallbladder wall uneven thickening. Laboratory tests showed: CA-125 151 U / m L, A