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患者,潘某,女,46岁,因下腹部胀痛1年入院。经查体及B超探查后诊断为子宫肌瘤,并于2000年7月7日行子宫全切除术。术后病理:子宫平滑肌瘤。术后两天排气,予半流饮食,进食后出现持续性全腹绞痛。查体:体温38.5℃,痛苦面容,腹膜刺激征阳性,腹部移动性浊音阳性,腹穿为桔黄色腹水,血WBC11.8×10~9/L,N 0.90,7月10日腹痛加重,无恶性呕吐,急查血Ams168u,腹水Ams336u,腹透提示不全梗阻,予禁食,胃肠减压等治疗。未见明显疗效。7月12日出现表情淡漠,休克状态,急诊剖腹探查,术中见腹腔少量淡黄色积液,全结肠充气扩张明显,小肠充血水肿,回盲部上20cm有一回肠憩室,约2cm×1.5cm,与周围肠管粘连,形成梗阻,其后长约20cm回肠肠管充血水肿更为明显,呈暗红色,未见缺血坏死灶,胰腺中度水肿,直肠后穹隆积脓约30ml,原术
The patient, Panmou, female, 46 years old, admitted to the hospital because of abdominal pain for 1 year. The diagnosis of uterine fibroids after examination and B-scanning was performed, and a total hysterectomy was performed on July 7, 2000. Postoperative pathology: uterine leiomyoma. Two days after surgery, the patient was discharged to a half-flow diet and sustained full abdominal colic after eating. Physical examination: body temperature 38.5°C, painful face, positive peritoneal irritation sign, positive abdominal shifting dullness, orange ascites in abdominal dissection, blood WBC 11.8×10-9/L, N 0.90, abdominal pain worsened on July 10, Malignant vomiting, acute blood Ams168u, ascites Ams336u, peritoneal dialysis incomplete obstruction, fasting, gastrointestinal decompression and other treatment. No obvious effect. On July 12th, she developed indifferent expression, shock status, emergency exploratory laparotomy, and a small amount of pale yellow effusion in the abdominal cavity during operation. The colon was inflated and inflated significantly, and the small intestine was congested and edema. There was an ileal diverticulum on the ileocecal region at 20 cm, approximately 2 cm x 1.5 cm. Adhesion with the surrounding bowel obstruction, obstruction, after about 20cm ileal intestine congestion and edema is more obvious, dark red, no necrosis, necrosis, pancreatic moderate edema, posterior rectal empyema empyema about 30ml, the original surgery