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患者男,12岁。因右下腹持续性疼痛渐加重,伴发热,在当地医院就诊,拟阑尾炎,用抗菌素治疗效果不佳,遂出现全腹疼痛,以急性阑尾炎、弥漫性腹膜炎收住我院。既往有慢性腹痛史。检查:全身浅表淋巴结不肿大。腹部稍胀,腹式呼吸较弱,全腹有压痛、反跳痛,腹肌紧张,以右下腹较显著。肝脾未触及,肝浊音界上移,移动性浊音(+),肠鸣音减弱,右下腹穿刺试抽阴性。术前X线腹透,右膈下见新月型透光区,随体位改变而变动,结合临床考虑消化道穿孔。入院第10天剖腹探查见乙状结肠中下段部
Male patient, 12 years old. Due to the continuous pain in the right lower abdomen, with increasing fever, with fever, treatment in the local hospital, intended to appendicitis, the effect of treatment with antibiotics is not good, abdominal pain occurs in the whole body, with acute appendicitis, diffuse peritonitis admitted to our hospital. There is a history of chronic abdominal pain. Check: The superficial lymph nodes are not swollen. The abdomen slightly bulges, the abdominal breathing is weak, the entire abdomen has tenderness, rebound tenderness, abdominal muscle tension, and the right lower abdomen is more pronounced. Liver and spleen were not touched, liver dullness was shifted upward, shifting dullness (+), bowel sounds were weakened, and right lower abdominal puncture was negative. Preoperative X-ray peritoneal dialysis, right crescent and see the crescent-shaped light transmission area, with the change in body position, combined with clinical considerations of perforation of the digestive tract. On the 10th day of admission, laparotomy was performed and the lower part of the sigmoid colon was seen