医師国家試験 第110回 問142

61歳の男性。自営業。旅客機内で耐え難い全身倦怠感を訴えた。2週間の仕事 を終えて東アジアのある国から帰国するところである。たまたま同乗していた医師 が機内アナウンスに呼応した。男性が現地の医療機関を昨日受診した際に渡された 紹介状の一部を示す。 The patient is a 61-year-old man with a complaint of general malaise. Distended abdomen has been developed in these two days. He has a long history of drinking. However, he has never been treated on alcoholic problems. On physical examination, his consciousness was clear. He had no fever. Icterus on his conjunctiva, several vascular spiders in his anterior chest and bilateral pretibial edema were observed. Moderate amount of ascites was detected by ultrasonography. Therefore, I strongly recommended him to consult a physician in his home country as soon as possible. 機内での現症 : 体温36.5°C。脈拍88/分、整。呼吸数12/分。腹部に圧痛を認 めない。 この情報から最も疑うべき疾患はどれか。