试题与答案

患者女,48岁。早餐进食煎鸡蛋后出现右上腹痛。追问病史,患者近半年数次发作性右上腹疼

题型:单项选择题 案例分析题

题目:

患者女,48岁。早餐进食煎鸡蛋后出现右上腹痛。追问病史,患者近半年数次发作性右上腹疼痛,为绞痛,多为夜间睡眠后发作,并向右肩部放射,无发热,偶有恶心,无呕吐。查体:肥胖体质,BP110/80mmHg,P90次/分,右上腹轻度压痛,无腹肌紧张。

提示:该患者病情进一步加重,伴畏寒、高热,最高体温达40℃,皮肤发黄,食欲减退,便秘、尿少、色深。查体:神志清楚,精神委靡,皮肤、巩膜黄染。R22次/分;BP110/75mmHg。两肺(-),腹平坦,右上腹有压痛,反跳痛可疑,无腹肌紧张,肠鸣音减弱,移动性浊音(-)。应首先考虑有()。

A.急性坏死性胰腺炎

B.急性化脓性胆管炎

C.亚急性肝坏死

D.胆囊癌侵犯肝总管

E.胆囊结石

F.暴发性肝衰竭

G.壶腹周围癌

答案:

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