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患者女性,68岁,有慢性胆囊炎胆石症病史6年,平时有轻度腹痛反复发作,于1990年3月2日入院。体格检查:皮肤巩膜无黄染,右上腹稍有压痛,无反跳痛及肌卫,肝肋下触诊不满意,脾未及。实验室检查:Hb89g/L,WBC5.4×10~9/L,NO.86,ESR50mm/h,B超检查胆囊明显增大,14.6cm×7.8cm,壁厚0.4cm,毛糙;囊内见2.0cm×1.4cm及1.8cm×1.0cm增强光团,后方有声影,另见大小不等、形态不一的强光团,并见5.2cm×6.3cm低回声及暗区,呈实质性团块。诊断为胆囊炎,胆石症,胆囊占位性病变待排。腹部CT检查示胆囊明显增大,呈球形,约7.7cm×7.6cm,壁薄,部分层面不清,胆囊内密度欠均匀,有多发大小不等的钙化灶。1990年3月15日行剖腹探查、胆囊切除术。
The patient female, 68 years old, had a history of chronic cholecystitis with cholelithiasis for 6 years. She had mild episodes of abdominal pain and was admitted to the hospital on March 2, 1990. Physical examination: There was no yellowing in the skin sclera, slight tenderness in the right upper quadrant, no rebound tenderness, and no muscle spasm. The liver was not satisfied with subcostal palpation. Laboratory examination: Hb 89g/L, WBC 5.4×10~9/L, NO. 86, ESR 50mm/h, B-ultrasound significantly increased gallbladder, 14.6cm×7.8cm, wall thickness 0.4cm, rough; inside the capsule 2.0cm × 1.4cm and 1.8cm × 1.0cm enhanced light mass, rear sound shadow, see also different sizes, different forms of light glare, and see 5.2cm × 6.3cm hypoechoic and dark areas, was a substantial group Piece. Diagnosis is cholecystitis, cholelithiasis, gallbladder space-occupying lesions to be discharged. Abdominal CT examination showed that the gallbladder was obviously enlarged, showing a spherical shape, about 7.7cm×7.6cm, thin wall, unclear part of the level, uneven density in the gallbladder, and multiple calcifications of different sizes. On March 15, 1990, laparotomy and cholecystectomy were performed.