女性，53岁，右上腹阵发性绞痛伴恶心呕吐3小时，胆囊泥沙样结石病史1年。查体：体温37℃，右上腹深在轻度压痛，无腹肌紧张，Murphy征阴性。
经保守治疗1天，出现皮肤巩膜黄染。查体：体温38.5℃，右上腹深压痛、反跳痛，肌紧张 (±)，此时可诊断为( )
A．急性坏死性胰腺炎
B．十二指肠溃疡穿孔并弥漫性腹膜炎
C．暴发性肝炎
D．急性胆囊炎
E．急性梗阻性化脓性胆管炎
参考答案：E
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| Hello. I'm Tom. I'm a middle school student. It's nice to meet you here. First, let me tell you __1__ about my family. There are five people in my __2__ . They are my mother, my father, my sister, my brother and me. My father is a worker. My mother is an English teacher. My sister is eighteen and my brother is sixteen. I'm fourteen. We__3__ go to the same school. We all enjoy __4__ football games. My __5__ is at West Street. There is a big tree and some small trees around my house. The big one is a pear tree and the small ones are apple __6__ ,__7__ there __8__ any pears or apples on them now. __9__ a photo of my house. In the photo, you can see threecats in my house. They are all black and white. We __10__ them very much. | |||
| ( ) 1 A. anything ( ) 2 A. school ( ) 3 A. two ( ) 4 A. seeing ( ) 5 A. bedsore ( ) 6 A. trees ( ) 7 A. but ( ) 8 A. isn't ( ) 9 A. He's ( ) 10 A. are liking | B. something B. house B. five B. looking at B. school B. rivers B. and B. is B. She's B. likes | C. thing C. room C. three C. watching C. room C. houses C. so C. are C. it's C. like | D. anyone D. family D. six D. looking D. home D. schools D. or D. aren't D. There's D. is liking |