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患者男,55岁。以右上腹不适伴发热10 d于2010年2月26日入院。患者10 d前无明显诱因出现右上腹不适、恶心、呕吐、腹痛等症状,伴发热。患者发病以来饮食尚可,大小便正常,体重未见明显变化。既往有乙型病毒性肝炎(乙肝)病史10年。体格检查:体温38℃,皮肤、巩膜无黄染,浅表淋巴结无肿大,心、肺检查未见异常。腹部平、软,右上腹轻压痛,无反跳痛。肝、脾肋下未及。辅助检查示丙氨酸转氨酶
Male patient, 55 years old. I was admitted to hospital on February 26, 2010 with discomfort in the right upper quadrant and fever for 10 days. Before 10 days, there was no obvious cause of right upper quadrant discomfort, nausea, vomiting, abdominal pain, and fever. Since the onset of the disease, the patient had a fair diet, normal urine, and no significant changes in body weight. The past had a history of hepatitis B (hepatitis B) for 10 years. Physical examination: Body temperature 38°C, no yellow staining of skin and sclera, no enlargement of superficial lymph nodes, no abnormalities in heart and lung examination. The abdomen is flat, soft, and the right upper abdomen is lightly tender and no rebound tenderness. The liver and spleen were not under the ribs. Auxiliary examination showing alanine aminotransferase