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患者,58岁,男性。因腹胀、纳差、乏力2个月,COP(+),于1987年7月8日入院。患者有血吸虫病治疗史,以后又频繁接触疫水,无肝炎、疟疾病史。体检:腹稍膨隆,腹壁静脉显露,腹围77cm,肝剑突下4.5cm,质硬,脾左肋缘下6cm。 患者入院后,经护肝支持疗法及对症治疗,自觉症状好转,腹围72cm。5d后下午5时上厕所大便,便后突感腹痛,呕吐,呕吐物无咖啡色液体。腹痛以左上腹明显,并放射至左肩和背部,左上腹有固定性浊音区。面苍白,心音低钝、BP60/20mmHg。考虑急性内出血,行腹腔穿刺为血性液体、腹
Patient, 58 years old, male. Due to bloating, anorexia, fatigue 2 months, COP (+), was admitted to hospital on July 8, 1987. Patients have history of treatment of schistosomiasis, and later frequent contact with water, no history of hepatitis, malaria. Physical examination: slightly bulging belly, abdominal veins revealed, abdominal circumference 77cm, liver xiphoid 4.5cm, hard, spleen left costal 6cm. Patients admitted to the hospital after liver support therapy and symptomatic treatment, symptoms improved, abdominal circumference 72cm. 5d after 5 o’clock on the toilet stool, after the sudden sensation of abdominal pain, vomiting, vomit no brown liquid. Abdominal pain obvious to the left upper abdomen, and radiate to the left shoulder and back, the left upper quadrant with fixed dullness. Pale face, low heart sound blunt, BP60 / 20mmHg. Consider acute hemorrhage, abdominal paracentesis for bloody fluid, abdomen