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患者女,25岁。突发中上腹部阵发性钻顶样剧痛2天,伴频繁呕吐,精神软弱。曾在院外补液抗炎治疗(具体药物不清楚),腹痛无减轻。于1994年1月11日入本院。体检:体温36.5℃,脉搏82次/分,有早搏,呼吸20次/分,两肺听诊正常,腹平软,右上腹压痛,无反跳痛,莫菲征(一),肝、脾未触及,肠鸣音正常。血红蛋白115g/L,白细胞数9.7×10~9/L,中性0.8,淋巴0.2。B超示胆总管内见两条平行光带,其后无声影. 入院后诊断为胆道蛔虫并胆道感染。给予抗炎、解痉、驱蛔、纠正水电解质失衡等治疗,但腹痛、呕吐不止。入院次日上午用Olympus OGF前视式内镜取蛔虫。在十二指肠降部,奥狄括约肌开口处见有约5～
Female patient, 25 years old. Suddenly in the upper abdomen Paroxysmal parietal top-like pain for 2 days, with frequent vomiting, mental weakness. Anti-inflammatory fluid treatment in hospital (specific drug is not clear), no reduction of abdominal pain. January 11, 1994 into our hospital. Physical examination: body temperature 36.5 ℃, pulse 82 beats / min, with premature beats, breathing 20 beats / min, both lung auscultation normal, abdominal soft, right upper quadrant tenderness, no rebound pain, Murphy sign Touch, bowel sounds normal. Hemoglobin 115g / L, white blood cell count 9.7 × 10 ~ 9 / L, neutral 0.8, lymph 0.2. B ultrasound showed two common light within the common bile duct, followed by no sound shadow.After admission, diagnosis of biliary ascariasis and biliary tract infections. Give anti-inflammatory, antispasmodic, drive roundworm, correct water and electrolyte imbalance and other treatment, but abdominal pain, vomiting. On the morning of admission, Olympus OGF front view endoscopy to take roundworms. In the descending part of the duodenum, Oddi sphincter see about 5 ~