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肝内胆管粘液腺癌致急性梗阻性化脓性胆管炎(AOSC)的病例在临床上较为罕见。本症的诊断与治疗独具特点,作者曾诊治1例,报告如下。女性,69岁。因右上腹隐痛半年,加重伴发热、黄疸10天入院。查体:T 38.5℃,Bp11/8kPa。巩膜皮肤黄染。肝剑突下4cm,边钝,质硬,触痛,肋下未及。血像:WBC 20.8×10~9/L,N 0.70。B超示:左肝有5cm×6cm区域呈网状改变,肝内外胆管扩张,左肝管及肝、胆总管有絮状回声,考虑左肝管及胆总管有脓性物及死蛔虫。既往无肝炎及胆石病史。于入院当晚急症手术,见腹腔少许淡黄色渗液,左肝内、外叶之间有一直径5cm肿块,边界不清,表面与膈肌粘连,余肝大小、
Cases of acute obstructive suppurative cholangitis (AOSC) caused by intrahepatic bile duct mucinous adenocarcinoma are rare in the clinic. The diagnosis and treatment of the disease have unique features. The author once diagnosed and treated 1 case. The report is as follows. Female, 69 years old. Because of the pain in the right upper quadrant for six months, he was aggravated with fever and jaundice admitted to hospital for 10 days. Physical examination: T 38.5°C, Bp 11/8kPa. Scleral skin yellowish. The liver xiphoid 4cm, blunt side, hard, tender, under the ribs. Blood image: WBC 20.8×10~9/L, N 0.70. B-ultrasound showed that the left liver had a reticular change of 5cm x 6cm. The bile ducts inside and outside the liver were dilated. The left hepatic duct, liver, and common bile duct had floccular echoes. Consider the purulent and dead worms in the left hepatic duct and common bile duct. Past history of hepatitis and gallstone disease. In the emergency surgery on the night of hospital admission, see a little yellowish exudate in the abdominal cavity. There is a 5cm diameter lump between the left and right liver and the outer leaves. The boundary is not clear, the surface adheres to the diaphragm, and the rest of the liver is