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1临床资料患者:男性,42岁。反复发热1月余,体温波动于38．5℃左右,伴有寒战,食欲减退,体重下降5kg。入院后查体:体温正常,巩膜无黄染,腹部无压痛,总胆红素28．6mmol／L。CT显示肝内胆管轻度扩张,胆总管扩张,直径1．8 cm,其下端十二指肠壶腹区见有直径1．0cm结节,增强后强化。CTA显示胰周大血管未见明显受累征象。印象诊断:胆总管下端癌。术前诊断为胆总管末端癌。行手术治疗,术中见胆总管增粗。
1 clinical data patients: male, 42 years old. Repeated fever more than 1 month, body temperature fluctuations at 38.5 ℃, accompanied by chills, loss of appetite, weight loss 5kg. Physical examination after admission: normal body temperature, scleral no yellow dye, no tenderness in the abdomen, total bilirubin 28.6mmol / L. CT showed mild intrahepatic bile duct dilatation, dilatation of the common bile duct, a diameter of 1.8 cm, the lower end of the ampulla of the duodenum see 1.0cm in diameter nodules, enhanced and strengthened. CTA showed no significant signs of peripancreatic vascular involvement. Impression diagnosis: common bile duct cancer. Preoperative diagnosis of common bile duct cancer. Surgical treatment, intraoperative see common bile duct thickening.