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患者女,18岁。打篮球时被他人肘部撞伤左上腹后,感左上腹隐痛,当晚腹痛加剧,2天后来我院诊治。查体:体温38.1℃,脉搏90次/分,呼吸23次/分,血压14/9kPa(1kPa=7.5mmHg),面色苍白,左上腹压痛、反跳痛明显,左上腹腹肌稍紧,移动性浊音(+),肠鸣音减弱。化验:血白细胞计数17.0×10~9/L,中性粒细胞0.90,血红蛋白131g/L。诊断性腹腔穿刺抽到不凝固血。诊断:外伤性脾破裂。入院后即在全麻下取左上腹经腹直肌切口行剖腹探查术,腹腔内积血1500ml 左右,小网膜囊内有凝血块约300g,在左横结肠系膜上方、胰尾和脾门之间发现一个20cm×15cm×10cm 大小肿块,除近胰尾侧有一
Female patient, 18 years old. When I was playing basketball, I was injured by the elbow of the other person and I felt pain in my left upper abdomen after abdominal injury. The abdominal pain worsened that night and I was diagnosed and treated in our hospital two days later. Physical examination: body temperature 38.1°C, pulse 90 beats/minute, breath 23 beats/minute, blood pressure 14/9kPa (1kPa=7.5mmHg), pale, left upper quadrant tenderness, rebound tenderness, abdominal muscles slightly tight, mobile Dirty (+), reduced bowel sounds. Laboratory tests: White blood cell count 17.0 x 10-9/L, neutrophils 0.90, hemoglobin 131 g/L. Diagnostic peritoneal puncture does not coagulate blood. Diagnosis: Traumatic splenic rupture. After admission, under the general anesthesia, the left upper abdomen was incised through a rectus abdominis muscle incision. The intraperitoneal hemorrhage was about 1500 ml, and the small omental sac had a clot of about 300 g. At the top of the left transverse colon, the pancreas and the splenic A 20cm x 15cm x 10cm lump was found between them, except for the caudal end of the pancreas