A 43-year-old man admitted into our hospital
in July 11 2010 presented with a 2-day history of right upper quadrant intense
pain associated with nausea, vomiting and followed by 5-day yellow coloration
of skin.
The patient
was diagnosed with gallstones a few years ago, but he denied a history of
chest or right upper abdomen trauma. His examination was nothing besides yellow
coloration of skin and sclera.
However, other problems were found during the
typical preoperative preparation. The chest X-ray revealed the right-side
diaphragm was elevated markedly. The initial and contrast-enhanced CT image
revealed calculus of common bile duct and the right-lobe of liver, gallbladder
and colon herniated into the thorax cavity, the latter was confirmed by barium
enema. According to the clinical manifestation and auxiliary examinations as
above, the patient was diagnosed with choledocholithiasis, congenital right
side diaphragmatic hernia.
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