患儿,男,5岁.因上呼吸道感染在门诊治疗.病后1周开始腹痛,以脐周及左中、下腹部明显,为持续性疼痛,呈阵发性加重,不向它处放射.伴有恶心、呕吐、吐出物为淡黄色粘液和食物,无腹泻.既往无类似腹痛史、门诊以“肠痉挛”收入内科住院治疗.经对症处理未见好转,仍有持续性腹绞痛伴腹胀,并停止排气3天,因而转外科诊治.检查:体温37.8℃,脉搏90次/分,呼吸24次/分,血压12/8kPa.急性痛苦病容,被动卧位.皮肤、粘膜无紫癜及出血点.巩膜无黄染.咽部及心肺未见异常.腹胀,无明显肠型及肌紧张.全腹压痛、反跳痛,尤以左中、下腹部为显著.肝脾未触及,全腹未扪及包块.肝浊音界缩小,移动性浊音(±).肠鸣音亢进.关节无红、肿、热、痛.肛门指诊,无大便梗塞,指套无血染.腹穿未抽出液体.周围血象:血红蛋白125g/L.红细胞4.3×10~(12)/L,白细胞13× Children, male, 5 years old due to upper respiratory tract infection in the outpatient treatment.After 1 week of onset of abdominal pain, to the umbilical cord and the left middle and lower abdomen is obvious, persistent pain, paroxysmal increase, do not radiate it elsewhere Accompanied by nausea, vomiting, discharge of light yellow mucus and food, no diarrhea in the past without a history of similar abdominal pain, outpatient “intestine cramps” income medical treatment in hospital.After the symptomatic treatment did not improve, there are still persistent colic With abdominal distension, and stop the exhaust for 3 days, so turn to surgical diagnosis and treatment.Check: body temperature 37.8 ℃, pulse 90 beats / min, breathing 24 beats / min, blood pressure 12 / 8kPa .Acute pain and disease, Purpura and bleeding point. Sclera no yellow dye. Pharynx and heart and lung no abnormalities. Bloating, no obvious intestinal type and muscle tension. Abdominal tenderness, rebound tenderness, especially in the left middle and lower abdomen was significant. , The whole abdomen without palpable mass. Liver dullness narrowed, mobility dullness (±). Bowel sounds hyperthyroidism. Joints red, swollen, hot, pain. Anal referral, no stool infarction, fingerless blood-stained. Abdominal wear did not pull out the liquid. Peripheral blood: hemoglobin 125g / L. Red blood cells 4.3 × 10 ~ (12) / L, white blood cells 13 ×