布氏杆菌病(又称布病)是由布鲁氏菌引起的急慢性多器官损害的传染病.本科遇见一例以脾肿大为主要表现的布鲁氏病报告如下;患者女性;42岁,牧民,西藏江达县人.一年前无明显诱因,发现左上腹有一无痛性包块,低热及全身出汗,曾有过两次便血史,在江达县医院就诊,因诊断不明,转我院外科,门诊“B”超检查诊断为脾脏占位性病变,于1993年8月入院.查体:一般情况尚可,呈慢性贫血貌、神志清、皮肤巩膜无黄染及出血点,浅表淋巴结未触及,血压17.3/10.7KPa,脉搏68次/分,呼吸20次/分,心肺正常,腹部平坦,腹壁浅静脉不怒张,肝颈静脉回流征阴性,肝上界在第五肋间,下界未扪及,脾大Ⅲ度,可扪及脾边缘,质地硬,轻度左右活动及轻度压痛,无腹水征.入院诊断为巨脾症,经实验室检查,大小便及周围血象正常,血型“O”,肝功和肾功正常,“B”超检查脾脏占位性病变.手术所见:1993年12月22日在“硬麻”下施行腹部探查脾脏切除术,术中见腹腔内有淡黄色液体100ml左右,肝左叶增大,质地软,色泽正常,脾脏明显肿大,脾重为650g,经常规摘除并送病检.病理观察:送检全切除脾脏及少许肝组织.脾大小为21×18cm×13cm,表面呈暗红及灰褐色相间,包膜完整.切面呈粉红色和暗红色,包膜轻度增厚,间质结构正常.另有肝组织一块,大小为1cm×1cm×0.8cm,表面呈 Brucellosis (also known as brucellosis) is caused by brucellosis acute and chronic multiple organ damage in infectious diseases .Bank met a case of splenomegaly as the main manifestation of brucellosis are as follows; Female patients; 42 years old, Pastoralists, people in Jiangda County, Tibet A year ago, no obvious incentive to find a painless mass in the left upper abdomen, fever and sweating, there have been two times of history of blood in the stool, in Jiang County Hospital for treatment, due to unknown diagnosis, Transferred to our hospital surgery, outpatient “B” ultrasonography diagnosis of splenic space-occupying lesions, admitted to hospital in August 1993. Physical examination: the general situation is acceptable, was chronic anemia appearance, clear consciousness, skin scleral no yellow dye and bleeding point , Superficial lymph nodes not touched, blood pressure 17.3 / 10.7KPa, pulse 68 beats / min, breathing 20 beats / min, normal heart and lungs, flat abdomen, superficial veins without ravages, liver and neck venous reflux syndrome, Five intercostals, the lower bound not palpable, splenomegaly Ⅲ degrees, palpable and splenic margin, texture hard, mild left and right activity and mild tenderness, no signs of ascites. Admission diagnosis of splenomegaly, after laboratory tests, urine And peripheral blood as normal, blood type “O”, normal liver function and renal function, “B” ultrasonographic examination of spleen occupying lesions .Surgical findings: 1993 12 On the 22nd under the “hard linen” underwent abdominal exploration splenectomy surgery intraperitoneal see the pale yellow liquid about 100ml, liver left lobe increased, soft texture, normal color, spleen significantly enlarged spleen weight of 650g, The routine removal and sentinel examination.Pathological observation: the whole removal of the spleen and liver tissue.Secondary spleen size is 21 × 18cm × 13cm, the surface was dark red and brownish white, the envelope is complete.The cut surface is pink and dark red , Mild thickening of the envelope, the normal structure of the interstitial.Another piece of liver tissue, the size of 1cm × 1cm × 0.8cm, the surface was