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肝癌黄疸多发生于晚期或继发硬化后,很少以初期症状出现,故梗阻性黄疸的鉴别诊断中较少考虑肝癌。本文报告一例肝细胞癌侵入胆道、脱落至肝外胆管造成梗阻性黄疸。病例;周××男,54岁,工人,住院号49878。病史为20天来渐进黄疸,皮肤骚痒、浅白便,以梗阻黄疸入院。查体,肝大右肋下4cm、中等硬、光滑、胆囊及脾未触及。B超:肝右叶增大增厚未见占位病变,胰腺正常。肝同位素扫描:右叶肿大放射分布不均,左叶及肝门区放射稀疏、缺损、脾显影。ERCP:胃十二指肠、乳头正常,造影胰管显
A large amount of jaundice occurs in late stage or secondary hardening, and rarely occurs with early symptoms, so the differential diagnosis of obstructive jaundice is less concerned with liver cancer. This article reports one case of hepatocellular carcinoma invasion of the biliary tract and loss of the extrahepatic bile duct resulting in obstructive jaundice. Case; Zhou × × male, 54 years old, worker, hospital number 49878. The history of the disease was progressive jaundice in 20 days. The skin was itchy and pale and was admitted to hospital with obstructive jaundice. Physical examination revealed that the liver was 4 cm below the right rib, hard and smooth, and gallbladder and spleen were not touched. B-ultrasound: There was no occupying lesion in the thickening of the right lobe, and the pancreas was normal. Hepatic isotope scan: The right lobe enlarges the radiation distribution, and the left lobe and portal area are sparse, defective, and spleen-developed. ERCP: normal gastroduodenal and papillary, angiographic pancreatic ducts