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病例报告:男,27岁。因上腹痛2d 伴恶心呕吐1d 余,于2004年4月13日入院。患者于4月11日晚饮白酒7两,12日上午出现上腹疼痛,无他处放射痛,弯腰、按压后减轻;无恶心、呕吐,无发热及腹泻。在当地卫生所按“胃炎”诊治,症状缓解。当晚3时腹痛加重,并出现恶心、呕吐10余次。未排气排便。13日晚9时疼痛难忍来诊。12年前曾因阑尾炎行阑尾切除术,10年前患肠梗阻1次,治疗后症状消失。入院查体:脉搏80次/min,呼吸16次/min,血压110/80 mmHg。发育正常,营养中等,神志清,急性痛苦病容,被动抱腹体位。腹软,脐周压痛无反跳痛,无肠形及蠕动波,移动性浊音(-),肠鸣音亢进。实验室检查:白细胞10.3×10~9/L,中性0.90,红细胞5.77×10~(12)/L,血红蛋白166g/L。血淀粉酶正常,尿淀粉酶增高(1151u/L)。腹透见多个气液平。初诊为急性胰腺炎、肠梗阻。入消化科治疗、观察。给予胃肠减压、解痉、补液、胰酶抑制剂及对症治疗后
Case Report: Male, 27 years old. 2d due to abdominal pain with nausea and vomiting more than 1d, on April 13, 2004 admission. Patients on the evening of April 11 drinking white wine 7 two two on the morning of the 12th, appeared on the morning of abdominal pain, no elsewhere radiating pain, bending over, relieve pressure; no nausea, vomiting, no fever and diarrhea. In the local health clinic press “gastritis ” diagnosis and treatment, symptoms relieved. At 3 o’clock that night, his abdominal pain aggravated and nausea and vomiting ten times. No exhaust defecation. At 9 o’clock on the evening of 9 painful visit. 12 years ago due to appendectomy appendectomy, 10 years ago suffering from intestinal obstruction 1, the symptoms disappeared after treatment. Admission examination: pulse 80 beats / min, breathing 16 times / min, blood pressure 110/80 mmHg. Normal development, moderate nutrition, delirious, acute pain, passive abdominal position. Abdominal soft, umbilical tenderness without rebound tenderness, no intestinal and peristaltic waves, shifting dullness (-), bowel sounds hyperthyroidism. Laboratory tests: white blood cells 10.3 × 10 ~ 9 / L, neutral 0.90, red blood cells 5.77 × 10 ~ (12) / L, hemoglobin 166g / L. Normal blood amylase, urinary amylase increased (1151u / L). Abdominal see multiple gas level. Newly diagnosed as acute pancreatitis, intestinal obstruction. Into the Department of Gastroenterology treatment, observation. Given gastrointestinal decompression, antispasmodic, rehydration, pancreatin inhibitors and symptomatic treatment