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患者,女,23岁,因腹痛、腹泻、发热7日,腹痛加剧伴呕吐10小时入院。查体:T39.5℃,Bp12/8 kPa,心肺正常,板状腹、全腹压痛反跳痛,以脐周为著。肝浊音界消失,肠鸣音弱。腹透发现隔下游离气影。诊断为消化道穿孔,即剖腹探查。术中发现穿孔有2处。其一在回肠末端,其二在横结肠中段。病变肠段壁厚僵硬,区域引流淋巴结肿大。手术行根治性肠段切除包括引流淋巴结和肠系膜。病理诊断为回肠结肠恶性淋巴瘤。
The patient, female, was 23 years old and was admitted to the hospital for 10 hours due to abdominal pain, diarrhea, and fever on the 7th, with increased abdominal pain and vomiting. Physical examination: T39.5°C, Bp12/8 kPa, normal cardiopulmonary, abdominal palsy, full abdominal tenderness, rebound rebound, with umbilical cord. Liver dullness disappeared and bowel sounds were weak. The peritoneal dialysis found a free gas shadow. The diagnosis was perforation of the digestive tract, that is, laparotomy. Two perforations were found during the procedure. One is at the end of the ileum and the other is in the middle of the transverse colon. The wall thickness of the diseased intestine is stiff and the drainage lymph nodes are enlarged. Surgical radical bowel resection included draining lymph nodes and mesentery. Pathological diagnosis of ileal malignant lymphoma.