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单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,CASE REPORT,Department of General Surger,May,12th, 2016,Medical Records for Admission,Name：,Sex: fem,ale,Age:,31,Registration,N,o,.:,Date of admission,：,Chief compliant,Two months after appendicectomy,；,R,ecurrent abdominal pain associated with fever,for one month,Present history 1,right ventral abdominal pain,，,2 months ago,appendicectomy in Hongkong,abdominal pain associated with fever,for one month,maximum body temperature,up to 38.9,There are no similar diseases in his family,Family History,right low abdominal pains tenderness,（,+,）、Rebound tenderness（,+,）,;,Physical Examination,B,lood routine,21-Apr,29-Apr,4-May,8-May,10-May,WBC,14.37,12.3,10.34,14.61,9.42,X109,/L,3.5-9.5,NEUT%,82.4,83.3,85.5,88.7,84.1,%,40-75%,RBC,4.82,4.8,4.74,4.49,4.36,X1012/L,3.8-5.1,HB,110,114,112,106,103,g/L,115-150g/L,PLT,398,373,389,413,370,X109/L,125-350X109/L,urine routine,LEU,3+,-,UWBC,44.3,/ul,0-23/ul,URBC,8.4,/ul,0-18/ul,EC,4.8,/ul,0-3/ul,BXBGBSY,8,/HPF,0-5,个,/HP,HXBGBSY,1.5,/HPF,0-3,个,/HPF,4/21,coagulation function,PT,15.3,s,10-14s,INR,1.33,APTT,37.9,s,23-35s,TT,18.2,s,14-21s,FBG,3.72,g/L,1.7-4.5g/L,Liver function test,4/21,TP,67.5,g/L,65-85g/L,ALB,34.1,g/L,40-55g/L,ALP,51.8,U/L,35-100U/L,GGT,23.2,U/L,7-45U/L,ALT,6.9,U/L,7-40U/L,AST,12,U/L,13-35U/L,Tumor marker,4/7,AFP,11.2,ng/ml,0.89-8.78ng/ml,CEA,0.48,ng/ml,0-10ng/ml,CA125,22.1,U/mL,0-35U/mL,CA153,5.5,U/mL,0-28U/mL,CA199,7.5,U/mL,0-37U/mL,LAB FINDINGS,I,mageological examination,:,1,、肝胆胰脾、双肾输尿管、膀胱、子宫、附件无殊。,2,、右下腹非均质性包块。,ESR,24,mm/h,0-20mm/h,CT,Description,：,右侧回盲部见斑片状软组织密度影及条索影，边缘毛糙，约,29x43mm,，增强明显不均匀强化，内低密度坏死去无强化，右侧腹壁下见略不规则环形强化影。阑尾区少量积气，见高密度结石夹留置，呈术后改变，周围见多个稍大淋巴结，增强明显强化。,CT,1,、阑尾术后改变并回盲部、阑尾周围脓肿，建议治疗后复查；,2,、阑尾周围多发淋巴结影；,3,、肝右叶后上段不典型小血管瘤多考虑，随访；,4,、阴道穹窿部少量积液，请结合临床考虑。,D,iagnosis,1.,appendicitis after appendectomy,2. Abdominal Abscess,Discusion,：,further treatment,?,
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