胆道新型隐球菌感染伴梗阻性黄疸一例
Chinese Journal of Clinical Hepatology（2006）
Abstract
1 临床资料
患者女,14岁.两个月前无明显诱因出现厌食、恶心、呕吐.1个月前出现全身皮肤、巩膜黄染、尿黄,大便陶土样.入院后查体T 38.2℃,Bp110/80mmHg,神清语利,全身皮肤、巩膜黄染,腹平坦,右上腹轻压痛,无反跳痛及肌紧张,莫非氏征阴性,肝脾未触及,肝区叩痛可疑阳性.余未见异常.肝胆B超示:胆总管内条状回声伴肝内、外胆管扩张.肝胆CT扫描:肝内肝管扩张;肝脏增大;脾大.行ERCP检查:肝门部胆管狭窄.遂行剖腹探查术,术中见胆总管上段及肝总管明显狭窄.管壁厚而质硬.取部分狭窄胆总管作病理学检查,术中冷冻切片报告:炎性肉芽肿改变,未见恶性肿瘤,遂行肝门胆管成型术并T管引流术,切除病变组织送病理.术后给予抗真菌治疗,痊愈出院.
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