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我院因医生对带状疱疹早期缺乏认识,将右上腹痛误诊为急性胆囊炎,现报告如下:例1:女,60岁。因右上腹阵发性疼痛10天入院。查体:痛苦貌,皮肤无黄染及丘疹,浅表淋巴结不肿大,心肺(—),腹软,右上腹有压痛,墨菲氏征(±)。B超示胆囊壁粗糙、增厚。血常规正常。入院诊断:急性胆囊炎。予静滴氨苄青霉素5g、金胆片口服治疗一周,仍感腹痛明显,经查右季肋区出现2簇绿豆大小而不融合的水疱疹。诊断为带状疱疹。给予对症治疗后症状缓解,痊愈出院。
Our hospital due to lack of early awareness of shingles, right upper quadrant pain misdiagnosed as acute cholecystitis, are as follows: Example 1: Female, 60 years old. Due to paroxysmal right upper quadrant pain 10 days admission. Physical examination: painful appearance, skin yellow and papules, superficial lymph nodes are not enlarged, cardiorespiratory (-), abdominal soft, right upper quadrant tenderness, Murphy’s sign (±). B ultrasound showed gallbladder wall rough, thickening. Normal blood. Admission diagnosis: Acute cholecystitis. To intravenous ampicillin 5g, jinbian tablets oral treatment for a week, still feel significant abdominal pain, check the right quarter rib area by two clusters of mung bean size but not the integration of water blisters. Diagnosis of shingles. After symptomatic treatment to relieve symptoms, discharged.