1、a femalewasabdominalpainfor6months，aggravated withfeverfor3a femalewasabdominalpainfor6months，aggravated withfeverfor3Historyofpresent6 months ago, the d middle and upper abdominal withoutanobviouscause.Thepainwasparoxysmal,絞痛andradiatedtheback，withnauseaandvomiting。Shevomitedgastriccontents。hadnofe

2、ver,nochills,no colorchangeinurineandeyes，nochestno dyspnea, no acid ion, no belching, no diarrhea, no melenaThe patient went to local hospital when thepain wasnt ved after4-hoursThe abdominal ultrasound showe“choledocholith（repor was seen。She was given antibiotics and fluid support, and the pain ve

3、d5 months ago，the pain appeared again，similar to ved after same treatment in local hospital。3 days ago，the againwithurineskin eyes，and wasnt ved after same treatment in local hospital。highest temperature was 39.5 centigrade。For further diagnosis treatmentthe patient went to our hospitalThe abdominal

4、 ultrasound showed “l(fā)ower is，cholecystitis，膽壁多發(fā)結(jié)晶，fatty liver”。The patient was hospitalized and with PastBileiongastritisfor2yearsReceivingovidduct阻斷術(shù)15yearsago. No. Noheartdisease.Nodiabetes. Nodrugfood al history and family history have no .PhysicalVitalBileiongastritisfor2yearsReceivingovidduct阻斷

5、術(shù)15yearsago. No. Noheartdisease.Nodiabetes. Nodrugfood al history and family history have no .PhysicalVital signs: Temperature centigrade; 77 beats per Respirations 18 breaths minute; Blood re 127/64 General: Alert, mild skin sclera icterus, cyanosis, no lymphadenopathy, no jugular venous , no palpa

6、ble llymphadenopathy.noerangiomaora.gsareclear,norales.Heartrhythmisregular,noAbdomen: Whole abdomen mild 膨隆, with mild hepatomegaly . there is an operation scar on lower abdomenMurphyssignwasnegative.Theshiftdullnesswasis，cholecystitis，膽囊壁多發(fā)結(jié)晶fatty liver”A 61y old female suffered from recurrent upp

7、er abdominal pain for monthsAndthepainA 61y old female suffered from recurrent upper abdominal pain for monthsAndthepainaggravatedwithfeverfor3daysPhysicalrevealedmildtendernessonupperabdomen，noreboundtendernessMurphys sign was Abdominal ultrasound showed choledocholithiasis, liver，膽壁多發(fā)結(jié)晶”:fattyovid duct阻斷術(shù)Treatment 1.Furtherexaminatio