患者,男,53岁,因“左上腹痛伴发热3d”为主诉入院。既往体健,否认外伤史。查体:T38.7℃,P82次/分,R20次/分,BP120/70mm Hg。神志清楚,急性病容,皮肤粘膜无苍白。腹平坦,无腹肌紧张,左中上腹压痛,无反跳痛,脾肿大、下极于脐平线下3cm处,质地较硬,左季肋部叩击痛,移动性浊音阴性, The patient, male, 53 years old, was admitted to hospital because of “left upper quadrant pain with fever 3d”. Past physical health, to deny the history of trauma. Examination: T38.7 ℃, P82 beats / min, R20 beats / min, BP120 / 70mm Hg. Conscious mind, acute illness, no pale skin and mucous membranes. Abdominal flatness, no abdominal muscle tension, left middle and superior abdomen tenderness, no rebound tenderness, splenomegaly, extremely below the umbilical cord at 3cm, the texture is hard, percussion pain in the left quarter rib, mobility dullness negative,