患者,男,61岁。5年前因胆石症,胆囊切除、胆总管切开取石,痊愈出院。5年来时有右上腹部疼痛、发烧,消炎治疗可以缓解。近半个月来,右上腹部疼痛加重,发烧高达40℃,并发现右上腹部有一肿物。恶心、呕吐,不能进食,伴有阵发性抽搐而急诊住院。查体:T38.8℃,脉搏100次/min,呼吸4次/min,血压12.0/8.0kPa。一般状态欠佳,时而发怒,烦燥不安,精神紧张,意识清。耳前叩击试 Patient, male, 61 years old. 5 years ago due to cholelithiasis, cholecystectomy, common bile duct stone removal, discharged. Over the past five years when the right upper quadrant pain, fever, anti-inflammatory treatment can be alleviated. Nearly half a month, the upper right upper abdominal pain increased, fever up to 40 ℃, and found a tumor in the upper right abdomen. Nausea, vomiting, can not eat, accompanied by paroxysmal convulsions and emergency hospitalization. Examination: T38.8 ℃, pulse 100 beats / min, breathing 4 times / min, blood pressure 12.0 / 8.0kPa. The general state of poor, sometimes angry, irritable, nervous, conscious. Ear knocking test