病人,男,66岁,因皮肤巩膜发黄20 d 入院。入院前20 d 无明显诱因出现全身皮肤及巩膜发黄,伴口苦纳差,无腹痛,继之出现全身皮肤瘙痒,小便发黄,以“阻塞性黄疸,结石性胆囊炎”收入我院。既往无特殊病史。入院查体:体温37℃,脉搏82次/min,呼吸20次/min,血压15/8 kPa,一般情况好,消瘦体型,全身皮肤,巩膜中度黄染,锁骨上下未扪及肿大淋巴结。心肺无异常,腹平坦,全腹软,剑突下深 The patient, male, 66 years old, was admitted to hospital because of yellowing of the skin and sclera for 20 days. 20 days before admission, there was no obvious cause of systemic yellowing of the skin and the sclera, pain and poor appetite, no abdominal pain, followed by systemic skin itching, urine yellow, with “obstructive jaundice, cholecystitis ” income hospital. There is no special medical history in the past. Admission examination: body temperature 37°C, pulse 82 beats/min, respiratory rate 20 breaths/min, blood pressure 15/8 kPa, general condition, weight loss, body skin, moderate yellow sclera, clavicle up and down and enlarged lymph nodes . No abnormalities in heart and lungs, flat belly, full abdomen, deep under xiphoid process