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頁籤選單縮合
題名 | Sequential Sonographic Changes of the Gallbladder in Hemobilia: Case Report of a Patient with Intrahepatic Duct Stones=膽道出血之連續性膽囊的超音波變化:肝內膽管結石之病例報告 |
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作者 | 郭仲謀; 郭仲煌; 張簡吉幸; Kuo, Chung-mou; Kuo, Chung-huang; Changchien, Chi-sin; |
期刊 | 長庚醫學 |
出版日期 | 19990900 |
卷期 | 22:3 1999.09[民88.09] |
頁次 | 頁541-545 |
分類號 | 415.456 |
語文 | eng |
關鍵詞 | 超音波; 膽道出血; 膽囊; 肝內膽管結石; Sonography; Hemobilia; Gallbladder; Intrahepatic duct stone; |
中文摘要 | 膽道出血的膽囊超音波變化,在以前的報告有不同的表現,包括回音性團狀病變, 低回音性團狀病變或散開性膽囊內腔回音病變。我們報告一例59歲男性具有兩側肝內膽管 結石的病人在膽道出血之連續性膽囊的超音波變化。於上消化道出血發生前的36小時,在 腹部超音波下膽囊擴張呈現高回音均勻可移動的團狀病變,在上消化道出血5天後,腹部超 音波呈現低回音而有高回音環繞的團狀病變,在出血7天後(當天停止出血),腹部超音波呈 現微弱低回音的團狀病變,出血9天後(停止出血2天後) 腹部超音波呈現散開的點狀回音, 最後在出血12天後病變消失。因此膽道出血之膽囊的超音波形態會依血塊隨時間溶血情形 而改變,此需要和膽囊癌,膽囊的結石、息肉、膽沙,急性壞疽症膽囊炎與膽囊蓄膿作鑑別 診斷。 |
英文摘要 | The sonographic features of hemobilia in the gallbladder have been reported with variation, including an echogenic mass, hypoechoic mass, and scattered intraluminal echoes. The sequential sonographic changes of hemobilia in the gallbladder were observed in a 59-year-old male patient with bilateral intrahepatic duct stones. The sonograms of hemobilia in the distended gallbladder initially showed a hyperechoic, homogeneous, movable mass-like lesion, 36 hours before the onset of upper gastrointestinal (UGL) bleeding. A hypoechoic mass-like lesion with a hyperechoic ring was found 5 days after the onset of UGI bleeding. A faint hypoechoic mass-like lesion was found 7 days after the onset of UGI bleeding (the day of no further bleeding). Scattered echoic densities were found 9 days after the onset of UGI bleeding, then disappearance of the lesion was noted 12 days after the onset of UGI bleeding. The sonographic patterns of hemobilia in the gallbladder vary depending on the timing of lysis of the blood clot. It should be differentiated from gallbladder cancer, a stone, a polyp, sludge, acute gangrenous cholecystitis, and gallbladder empyema. |
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