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病例介绍女性患儿,五岁。因皮肤及巩膜黄染、进行性加重一个月,伴右上腹疼痛,纳差,尿黄,大便陶土色。于1990年8月4日以“阻塞性黄疸”诊断住院。体检:发育营养一般。全身皮肤粘膜中度黄染。心肺正常,腹软,右上腹触及7cm×6cm肿块,质硬,不活动。肝肋下2.5cm,剑突下3.5cm。Ⅱ75U,VDB直接迅速反应,GPT 3.7U,r—GT 4.2U,AKP 9U,白细胞5.4×10~9/L。B超:肝内外胆管扩张,总胆管2.3cm,胰头区见8.5cm×6.1cm中等不均回声光团。钡餐造影示十二指肠圈扩大。手术所见:肝肿大,胆汁淤积,胆总管扩张,胆囊13cm×7cm×6cm。胰头、体部有14cm×13
Case presentation Female child, five years old. Due to yellowing of the skin and sclera, it was progressively worsened for one month, with pain in the right upper quadrant, anorexia, urine yellow, and stool clay. On August 4, 1990, the hospital was diagnosed with “obstructive jaundice.” Physical examination: General development and nutrition. Systemic skin and mucous yellow dyeing. Cardiopulmonary normal, abdomen soft, right upper quadrant touch 7cm × 6cm mass, hard, inactive. Liver ribs 2.5cm, xiphoid 3.5cm. II75U, VDB reacts quickly, GPT 3.7U, r-GT 4.2U, AKP 9U, WBC 5.4×10~9/L. B-mode ultrasound: The bile ducts in the liver were expanded, the common bile ducts were 2.3cm, and the 8.5cm x 6.1cm moderately inhomogeneous echo group was seen in the pancreatic head area. Barium meal imaging showed enlargement of the duodenal loop. Surgical findings: Hepatomegaly, cholestasis, common bile duct dilation, gallbladder 13cm × 7cm × 6cm. Pancreas head and body are 14cm×13