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1病例报告患者男,55岁。因间歇性腹痛、腹胀7天,加重伴呕吐、肛门停止排气排便1天,由外院转至我院,外院诊断为急性胃肠炎。既往无腹部手术史。查体:急性面容,腹部膨隆,全腹部压痛、反跳痛,以中下腹明显,腹肌稍紧张,全腹未触及包块,肝脾触诊不满意,腹部叩诊呈鼓音,肝肺相对浊音界缩小,肝肾区无叩击痛,移动性浊音阳性,肠鸣音1~2次/min,可闻及气过水声。入院急诊行腹部立位X线片提示:气腹、肠梗阻;CT提示:气腹,腹腔积液,肠腔见积气积液明显、见气液平面,提示肠梗阻。血常规示:白细胞计数23.3×109/L,中性粒细胞0.921。诊断性腹腔穿刺抽出浑浊脓液。入院诊断:急性弥散性腹膜炎;绞榨性肠梗阻并肠坏死破裂?急诊行剖腹探查术,术中见腹腔有
1 case report Patient male, 55 years old. Due to intermittent abdominal pain, abdominal distension for 7 days, aggravating with vomiting, anal defecation exhaust 1 day, transferred from outside the hospital to our hospital, the hospital diagnosed as acute gastroenteritis. No past history of abdominal surgery. Physical examination: acute face, bulging abdomen, total abdominal tenderness, rebound tenderness, obvious in the lower abdomen, abdominal a little nervous, the whole abdomen without touching the mass, liver and spleen palpation are not satisfied, abdominal percussion was drum sound, liver and lung relative Voiced sound sector narrowing, perling area without percussion pain, mobility dullness positive, bowel sounds 1 to 2 times / min, can be heard and gas over water sound. Admission emergency line abdominal standing X-ray tips: pneumoperitoneum, intestinal obstruction; CT tips: pneumoperitoneum, peritoneal effusion, see the intestine fluid accumulation was obvious, see the gas-liquid level, suggesting intestinal obstruction. Blood showed: white blood cell count 23.3 × 109 / L, neutrophils 0.921. Diagnostic paracentesis pulls turbid pus. Admission diagnosis: Acute diffuse peritonitis; Sow bowel obstruction and necrosis of the intestine? Emergency line laparotomy, intraoperative abdominal see