患者 ,男 ,54岁。因晨起漱口时突发左上腹剧痛并迅及全腹 6h入院。体检 :脉搏 1 32次 /min,血压 75/30 mm Hg( 1 mm Hg=0 .1 33k Pa) ,呼吸 31次 /min,神志清楚 ,急性痛苦面容 ,被动体位 ,面唇苍白 ,皮肤湿冷。腹膨隆 ,全腹压痛、反跳痛 ,肌紧张明显 ,有移动性浊音 ,肠鸣音消失 Patient, male, 54 years old. Suddenly left upper abdomen pain due to early morning mouthwash and fasting 6h admission. Physical examination: pulse of 32 times / min, blood pressure of 75/30 mm Hg (1 mm Hg = 0.1133k Pa), breathing 31 beats / min, conscious, acute painful face, passive position, pale face, skin wet. Abdominal bulging, total abdominal tenderness, rebound tenderness, muscle tension obvious, there is mobility dullness, bowel sounds disappear