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1 病历摘要例1,女,35岁。因上腹持续性疼痛5天、发热2天就诊,以“腹痛待查”收住内科,入院第3天患者出现胸闷、呼吸困难、呕血两口。胸片示:纵隔严重感染和假性主动脉瘤形成。左上纵隔主动脉弓水平处见一半弧形突出影,边缘光整,基底宽9cm,高3.5cm。食管钡餐透视示:食管纵隔瘘形成。追问病史,1周前患者有误吞鸡骨史,当时强吞馒头2个,继续进食。体检:神清,急性病容,口唇轻度紫绀,呼吸28次/min,心跳100次/min,血压12/7kpa。给予禁
1 case summary 1, female, 35 years old. Due to persistent upper abdominal pain for 5 days, 2 days fever treatment, “abdominal pain pending investigation” to receive internal medicine, admitted to the hospital the first 3 days of chest tightness, difficulty breathing, hematemesis two. Chest radiograph showed severe mediastinal infection and pseudoaneurysm formation. The left upper mediastinum aortic arch see half of the horizontal arc prominent shadow, edge finishing, the base width 9cm, height 3.5cm. Esophageal barium meal perspective: Esophageal mediastinal fistula formation. Asked history, 1 week before the patient had swallowing history of chicken, then strong swallow 2, continue to eat. Physical examination: Shen Qing, acute disease, lips mild cyanosis, breathing 28 times / min, heart rate 100 beats / min, blood pressure 12 / 7kpa. Give ban