หมอคะ ชายคนนี้เขาดป็นโรคถุงน้ำดึอักเสบเฉียบพลันใช่มั้ยคะ A 57-year-old man was admitted through the emergency room with a 2-day history of progressively increasing abdominal pain in the RUQ, associated with nausea and general weakness. On examination, he was febrile, but was not jaundiced. The abdominal was tender, particularly in the upper right quadrant, where the gallbladder was palpable with a positive Murphy’s sign. Laboratory tests showed a white blood cell count of 17,000/mm2 . C-reactive protein of 48 mg/dl. Other blood test were normal. Abdominal ultrasound demonstrated a thickness gallbladder wall and a single giant pear-shaped gallstone (16 cm. long, 7.8 cm. width). No abnormality was detected in the biliary tract, and there was no intra-abdominal collection of fluid. Classical operation was carried out as an emergency on the day of admission. The patient did well postoperatively, and was discharged in good condition on the fifth day.