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患者女性,30岁,甘肃籍。因上腹持续性痛三年伴乏力,纳差在当地医院抗结核治疗一月无效转入我院。临床检验未见浅表淋巴结肿大及黄疸,心肺未获阳性体征。腹软,肝大右肋下6指、质硬、边钝、不光滑、触痛显著。脾未扪及、叩无移浊。实验室检查肝功正常,甲胎蛋白、癌胚抗原及包虫间接血凝试验二次阴性,包虫皮内试验强阳性。超声检查见肝肿大,右肝实质内正常结构紊乱,血管纹理不清,可见多个大小不等的团块状和结节状实质性回声,边界不清,未见包膜回声。各结节的回声强度不一,均有明显的声衰减,并见点状及小圈状钙斑强回声。其中一个较大的结节中心部可见形状不规则的液性暗区,无明确囊壁。各团块及结节状回声内均未采到多普勒血流信号。超声诊断报告为肝包虫病。
Female patient, 30 years old, Gansu nationality. Due to persistent upper abdominal pain for three years with fatigue, anorexia in the local hospital anti-TB treatment invalid January transferred to our hospital. Clinical examination showed no superficial lymph nodes and jaundice, heart and lungs were not positive signs. Abdominal soft, right big rib 6 fingers, hard, blunt, not smooth, significant tenderness. The spleen is not palpable, knocking no moving cloud. Laboratory tests normal liver function, a-fetoprotein, carcinoembryonic antigen and hydatid indirect hemagglutination test negative, hydatid cyst tests strongly positive. Ultrasound examination showed hepatomegaly, the normal structure of the right liver parenchyma, vascular texture is unclear, showing a number of unequal sizes of clumps and nodular echo, the boundary is unclear, no envelope echo. The echo intensity of each nodule varies, both have significant sound attenuation, and see punctate and small ring-shaped calcium echogenic. One of the larger nodules in the center showed irregularly shaped liquid dark areas with no clear wall. No intracranial mass and nodular echo within the Doppler blood flow signal. Ultrasound diagnosis of liver hydatid disease.