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标题: CT33765:F59Y胆囊切除，胆总管横断胆总管空肠（十二指肠？ [打印本页]

作者: 37度 时间: 2011-5-18 22:27
标题: CT33765:F59Y胆囊切除，胆总管横断胆总管空肠（十二指肠？
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作者: ljj8935 时间: 2011-5-18 22:42
1:低位胆管梗阻并肝内外胆管扩张，胆总管占位待排，建议ERCP或者MRCP。
2：胆囊切除术后综合征：小胆囊并炎症

作者: linyiming 时间: 2011-5-18 23:57
胆总管空肠（十二指肠？）吻合术后：胆管下段见块状软组织影，考虑：术后复发可能？
肝内胆管扩张，低位性梗阻。建议ERCP或者MRCP
胆囊术后改变。

作者: 卜一 时间: 2011-5-19 06:39
1:低位胆管梗阻并肝内外胆管扩张，胆总管占位待排，建议ERCP或者MRCP。
2：胆囊切除术后改变。

作者: zsl6918 时间: 2011-5-19 07:17
肝内胆管扩张，肝门部胆总管管壁均匀增厚，并可见异常强化，符合炎性改变

作者: 施明 时间: 2011-5-19 08:41
胆管扩张mrcp看看

作者: yhb 时间: 2011-5-19 09:15
1:低位胆管梗阻并肝内外胆管扩张，胆总管占位待排，建议ERCP或者MRCP。
2：胆囊切除术后改变。

作者: 吴医师 时间: 2011-5-19 09:35
1:低位胆管梗阻并肝内外胆管扩张，胆管细胞癌？建议ERCP或者MRCP。
2：胆囊切除术后改变。

作者: 看图说话 时间: 2011-5-19 20:35
还要考虑肝硬化伴肝Ca可能，建议查AFP、CEA。

作者: jsdtd 时间: 2011-5-19 20:44
1.胆囊切除术后，胆道残部慢性炎症可能大，建议MRCP排除其他。
2。肝内胆管积气，提示胆囊切除术后改变可能，化脓性胆管炎不能排除
3。肝右叶前段及肝左叶内侧段肝脓肿可能，并局部异常灌注

作者: ysxyy 时间: 2011-5-19 21:27
F59Y胆囊切除，胆总管横断胆总管空肠（十二指肠？）吻合术后10年间断上腹疼痛
这个病人应该再追问一下病史,十年前为什么要作胆肠术;是因为肿瘤还是其它;

胆管癌好像不能除外;

作者: ysxyy 时间: 2011-5-19 21:38
虽然可以看到胆总管下段扩张,如图

但是这个病人是作过胆肠吻合术后的病人;
他十年前把胆总管接到肠管的哪个部位我们并不明确,故这段胆总管扩张对疾病的诊断意义不大;
如果有可能的话,应该找到术后的片子作对比;

作者: ysxyy 时间: 2011-5-19 21:46
还应该查一下胸部;

欢迎光临医影在线 (http://bbs.radida.com/bbs/)

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