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患者61岁,住院号880.该患无诱因全腹痛12小时,持续性加重,无恶心呕吐等胃肠道症状,门诊以消化道穿孔收入外科.闭经15年,否认消化道溃疡及其它病史.检查:T37.6℃,P100次/分,Bp9.3/6.7kPα,急性病容,腹部膨隆,全腹明显压痛、反跳痛及肌紧张,肠鸣音消失.WBC 26×10~9/L,N0.88.X 线片可见膈下有游离气体.遂以消化道穿孔、泛发性腹膜炎、中毒性休克的诊断急诊行剖腹探查术.术中见腹腔积脓1000ml,恶臭味,部分肠壁充血,水肿并敷有脓苔.探查未见胃肠道穿孔,肝、脾、胰、肾未见积脓区.遂向下探查,见宫底部有
The patient was 61 years old and hospitalized 880. The patient had no pain due to full abdominal pain for 12 hours, persistent aggravating, no nausea and vomiting, and other gastrointestinal symptoms. Outpatients received surgical perforation of the digestive tracts for 15 years and denied peptic ulcer and other medical history. Check: T37.6 ℃, P100 beats / min, Bp9.3 / 6.7kPα, acute disease, bulging abdomen, abdominal tenderness, rebound tenderness and muscle tension, bowel sounds disappear .WBC 26 × 10 ~ 9 / L , N0.88.X line shows the diaphragm there is free gas.Subsequently to the digestive tract perforation, peritonitis, toxic shock diagnostic emergency laparotomy surgery see intraperitoneal empyema 1000ml, bad smell, part of Intestinal wall congestion, edema and deposited with pus moss.Prospecting no gastrointestinal perforation, liver, spleen, pancreas, kidney no suppurative area.So then exploration, see the bottom of the palace have