Case 27

 An eighty one-year-old male was transported by an ambulance for vomiting, abdominal pain and diarrhea for a couple of days. He had not dined and drunk anything since the day before he was transported. He previously experienced liver abscess, ischemic coronary disease and emphysema. He had a habit of tasting alcohol and smoking. The possible yellow discoloration on his skin was found. Body temperature at admission: 37.6 ℃.
 Laboratory test: white blood cells (WBC) 17690/ mm³; CRP 38.17 mg/dl; neutophils 91.0 % (40-71); AST 150 U/L (12-36); ALT 323 U/L (6-43); ALP 855 U/L (100-340); Creatinin 2.03 mg/dL; γGT 866 U/L (11－64); Total bilirubin 2.99 mg/dL; LDH 351 U/L: Blood sugar 192 mg/dL.
 He received CT at admission for further examination and MRI in the following day.

What is the appropriate imaging diagnosis ?

a. Liver abscess

b. Cholecystitis

c. Duodenal diverticulum

d. Cholangitis

  1.a, b   2. b, c   3. c, d   4. a, d   5. all

answer

2016.10.12