例1,男,81岁,下腹隐痛3个月。人院前半天,下腹部疼痛加重,呈阵发性胀痛,呕吐一次为胃内容物。腹部稍膨隆,以中下腹明显,未见明显肠形,腹肌稍紧张,中下腹明显压痛。肛检;直肠壁空虚,未及肿物。钡剂灌肠:示乙状结肠癌并梗阻。人院后予胃肠减压,输液、抗炎等治疗,入院后3h病人烦躁不安,四肢冰冷,血压降至11/7kPa,予加快输液扩容,使用多巴胺升压,并行急诊手术,术中发现结肠肿物位于乙状结肠下段4cm×6cm,以上肠管明显扩张达5~6cm,全结肠,末段回肠肠壁坏死,相应肠系膜血管未找到血栓。行全结肠切除,回肠造瘘术,病人术中、术后均需多巴胺维持血压,术中、术后尿少、无尿,术后当晚死于中毒性休克、多器官功能衰竭。例2,男,63岁,中下腹隐痛2d,加重6h,伴呕吐,吐出胃内容物。腹稍胀,未见明显肠形,腹肌紧张,全腹压痛,反跳痛,无移动性浊音,肠鸣音减弱,肛检:直肠壁空虚,未触及肿物,KUB示;结肠梗阻。入院后予胃肠减压、补液、抗炎等处理,并做好术前准备,入院后lh行急诊手术,术中发现乙状结肠下段肿瘤,5cm×6cm,质硬,以上肠管明显扩张达6~8cm,结肠、盲肠肠壁变黑,坏死,结肠相应肠系膜血管搏动减弱,未找到血栓,行全结肠切除,回肠末段造瘘术,手术顺利,术后恢复良好。 Example 1, male, 81 years old, had pain in the lower abdomen for 3 months. In the first half of the day in hospital, the pain in the lower abdomen aggravated. The patient developed paroxysmal pain and vomited once as stomach contents. The abdomen was slightly bulging, with a clear mid-lower abdomen, no obvious bowel shape, slight abdominal muscle tension, and marked tenderness in the middle and lower abdomen. Intestine; empty rectal wall, no tumor. Barium enema: shows sigmoid colon cancer and obstruction. After being hospitalized for gastrointestinal decompression, infusion, anti-inflammation and other treatments, the patient was irritated 3 hours after admission, cold limbs, blood pressure dropped to 11/7kPa, to speed up the infusion expansion, use dopamine boost, concurrent emergency surgery, intraoperative findings The colon mass was located 4cm×6cm in the lower segment of the sigmoid colon, and the above intestine was significantly expanded to 5-6cm. The colon of the entire colon and distal ileum was necrotic, and the corresponding mesenteric vessels failed to find a thrombus. All patients underwent colon resection and ileostomy. The patients required dopamine for blood pressure during and after surgery. During and after surgery, the patients had less urine and no urine. They died of toxic shock and multiple organ failure the night after surgery. Example 2, male, 63 years old, suffered pain in the lower abdomen for 2 days, aggravated for 6 hours, accompanied by vomiting, and spit out stomach contents. Little abdominal swelling, no obvious intestinal shape, abdominal muscle tension, abdominal tenderness, rebound tenderness, no moving dullness, weakened bowel sounds, rectal examination: rectal wall empty, untouched tumor, KUB showed; colonic obstruction. After admission, he was given gastrointestinal decompression, rehydration, anti-inflammation, etc., and preoperative preparations were performed. After admission, he underwent emergency surgery lh. The lower sigmoid colon tumor was found to be 5cm×6cm in the operation, which was hard, and the above intestine was significantly expanded to 6~ 8cm, colon, cecum intestinal wall darkening, necrosis, the corresponding mesenteric vascular pulse weakened in the colon, no thrombus found, line of colon resection, ileal end of ostomy, the operation was smooth, postoperative recovery.