【摘 要】
：
患者男,56岁.因转移性右下腹疼痛2d入院.32年前有右腹股沟斜疝修补手术病史.体查:急性痛苦貌.腹平坦,剑突下及右腹部压痛,右下腹肌紧张及反跳痛,未扪及包块,腹水征阴性,肠鸣
【机 构】
：
湖南省湘潭市韶山医院外科,湖南,湘潭,411300
论文部分内容阅读
患者男,56岁.因转移性右下腹疼痛2d入院.32年前有右腹股沟斜疝修补手术病史.体查:急性痛苦貌.腹平坦,剑突下及右腹部压痛,右下腹肌紧张及反跳痛,未扪及包块,腹水征阴性,肠鸣音减弱.血红蛋白132g/L,白细胞8.6×109/L,中性粒细胞0.72,血淀粉酶97U/L,腹穿抽出血性渗液.抹片:脓球+/Hp,细胞+++/Hp,腹部透视:右上腹肠腔积气,未见异常扩张及液平面,膈下未见游离气体.B超检查示:右髂部腹膜下少许液暗区.诊断:阑尾炎并腹膜炎.行急症手术,术中见距胃大弯下12cm处大网膜逆时针方向扭转5圈,远端变黑、坏死,下端插入原斜疝内环口内嵌顿.将坏死大网膜复位后切除,腹内修补内环口.术后诊断:嵌顿性右腹股沟斜疝,继发性大网膜扭转坏死.病理报告:大网膜坏死.
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