患者男性,34岁。无明显诱因出现上腹部疼痛伴恶心、呕吐,呕吐物为胃内容物;无排气、排便,疼痛呈持续性钝痛,无发热、寒战、心悸、胸闷、气短等症状。患者曾于9个月前行“胃穿孔修补术”。查体:腹部稍膨隆,腹式呼吸存在,无腹壁静脉曲张,未见肠型及蠕动波,全腹硬如板状,有压痛及反跳痛,未触及包块,肠鸣音消失。X线平片示双侧膈肌下 The patient was 34 years old. There was no obvious cause of upper abdominal pain with nausea and vomiting. The vomit was stomach contents; there was no exhaust and defecation, the pain was persistent dull, and there was no fever, chills, palpitations, chest tightness, shortness of breath and other symptoms. The patient had performed “gastric perforation repair” 9 months ago. Physical examination: Abdominal bulging, abdominal breathing, no abdominal wall varices, no intestinal and peristaltic waves, full abdominal hard as plate, tenderness and rebound tenderness, no palpable mass, bowel sound disappeared. X-ray film showing bilateral diaphragmatic muscles