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患者男性,16岁,中腹部钝痛半个月,发烧,恶心、呕吐,为胃内容物。查体:T:38℃,右肺呼吸音弱,肺肝界在右锁骨中线第五助间,全腹压痛,反跳痛,轻度肌紧张,移动性浊音阴性,肠鸣音减弱。化验:血常规W_(bc):21.4×10~9/L,中性:90％,胸片:右侧反应性胸膜炎,中等量积液,B超:肝右叶炎性病灶,腹腔内中下腹部化脓性包块,胞腔积液。临床诊断:多发性肝脓肿,腹腔脓肿,右侧反应性胸膜炎,胸腔积液。 手术治疗:入院行右侧胸腔闭式引流术,引流出黄色米汤样液体1500ML,剖腹探查见肝右前叶脏面有一2.5×3.5Cm~2炎性破溃灶,大网膜广泛水肿,呈暗红色,右下腹部见一8×10Cm~2大小
The patient was male, 16 years old, with dull pain in the mid-abdomen for a half month, fever, nausea, and vomiting as stomach contents. Physical examination: T: 38°C. The respiratory sounds of the right lung were weak. The lung and liver sectors were in the middle of the right midclavicular line. The whole abdominal tenderness, rebound tenderness, mild muscular tension, mobile dullness were negative, and the bowel sounds were weakened. Test: Blood routine W_(bc): 21.4×10~9/L, neutral: 90%, chest X-ray: right reactive pleurisy, moderate effusion, B-ultrasound: right lobe inflammatory lesion, intraperitoneal Lower abdomen purulent mass, cell effusion. Clinical diagnosis: multiple liver abscess, abdominal abscess, right reactive pleurisy, pleural effusion. Surgical treatment: Admission to the hospital closed right thoracic drainage, drainage of yellow rice soup-like liquid 1500ML, exploratory laparotomy see the right anterior leaf of the liver has a 2.5 × 3.5Cm ~ 2 inflammatory lesions, omental extensive edema, dark Red, see the right lower abdomen a size of 8 × 10Cm ~ 2