Author Archives: Dr. Li

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About Dr. Li

I am a professional surgeon based in Beijing, China.

Main Clinical Manifestations of Breast Cancer

Breast cancer arises from the terminal duct-lobular unit and may remain in-situ or invade surrounding tissue. Symptom patterns reflect tumour biology, anatomical location, and host response. Early recognition improves oncological outcome; therefore, any new, persistent breast change warrants triple assessment. Painless palpable massA solitary, firm-to-hard nodule with irregular or spiculated borders is most common. Fixation to pectoral fascia or skin reduces mobility and creates tethering. Nipple-areolar changesRecent nipple inversion, persistent eczematous scaling (Paget disease), or spontaneous serosanguinous/bloody discharge indicates underlying malignancy. Ulceration or fungation denotes locally advanced disease. Skin alterationsDimpling along Cooper ligaments, peau d’orange from lymphatic obstruction, or erythematous... Learn more

Main Clinical Manifestations of Chronic Cholecystitis

Chronic cholecystitis denotes persistent, low-grade inflammation of the gall-bladder wall, usually in the setting of recurrent mechanical irritation by gallstones or, less commonly, chronic infection or metabolic deposition. Symptoms are episodic and less dramatic than those of acute cholecystitis, but they may culminate in fibrosis, loss of function, or acute exacerbation. Recurrent biliary colicEpisodic, post-prandial right-upper-quadrant or epigastric pain lasting 15–60 min, often precipitated by fatty foods and radiating to the inter-scapular region or right shoulder. Pain is typically self-limiting but becomes more frequent over time. Dyspeptic syndromeEarly satiety, eructation, bloating, and nausea reflect impaired gall-bladder emptying and coexist with... Learn more

Main Clinical Manifestations of Acute Cholecystitis

Acute cholecystitis is acute inflammation of the gall-bladder wall, initiated most often by cystic-duct obstruction with secondary bacterial infection. The clinical picture evolves over hours, and recognition of its characteristic features guides early imaging, antibiotic therapy, and timely surgical intervention. Right-upper-quadrain painPersistent, often severe pain begins beneath the costal margin, may radiate to the right scapula or inter-scapular region, and is exacerbated by deep inspiration or movement. Pain typically lasts > 6 h and is unrelenting. Murphy signInspiratory arrest elicited by palpation of the right upper quadrant during deep inspiration is a reliable physical finding; a positive Murphy sign has... Learn more

Main Clinical Manifestations of Portal Vein Thrombosis

Portal vein thrombosis (PVT) is the partial or complete occlusion of the portal venous system by thrombus. Presentation is determined by the tempo of obstruction (acute vs. chronic), the extent of mesenteric involvement, and the presence of underlying cirrhosis or malignancy. Symptoms range from incidental imaging findings to life-threatening intestinal ischemia. Abdominal painColicky or constant upper-abdominal discomfort is the commonest early feature, reported in up to 90 % of acute cases. Pain may be non-specific, but when disproportionate to physical signs it heralds mesenteric vein extension and impending bowel infarction . Fever and systemic inflammatory responseLow-grade pyrexia, rigors, and elevated... Learn more

Main Clinical Manifestations of Biliary Tract Tumours

Biliary tract tumours comprise neoplasms of the gall-bladder, cystic duct, extra-hepatic bile ducts, and intra-hepatic bile ducts. Most are malignant (gall-bladder carcinoma, cholangiocarcinoma) and present late; benign lesions are rare and usually detected incidentally. Symptom patterns reflect anatomical location, growth morphology, and degree of biliary obstruction. Painless obstructive jaundiceProgressive conjugated hyper-bilirubinaemia with scleral icterus, dark urine, and acholic stools is the hallmark of hilar or distal cholangiocarcinoma and of advanced gall-bladder carcinoma. Pruritus is often intense and may precede visible icterus. Right-upper-quadrain painA constant dull ache or vague heaviness is typical of gall-bladder cancer; intermittent colicky pain suggests concomitant cholelithiasis... Learn more