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刘某某,男,42岁。主诉:脐周持续胀痛,阵发性加重20余天。现病史:伴恶心、呕吐胃内容物及胆汁数次,纳差,消瘦乏力,大便暗褐或黄,量少,急诊入院。既往史有阑尾浓肿2年多,1年前行阑尾切除术。体检:T37℃,P84次/分,R21次/分,BP14/10kPa。表情痛苦、乏力,消瘦,脱水貌(Ⅱ°),脸色苍白,两侧腹股沟可扪及数个黄豆大小淋巴结及触压痛,心、肺(-),腹部见数处肠型,脐右见长约8cm～10cm 切口疤痕,腹肌稍紧,未触及明显包块,满腹触、压痛及反跳痛。实验室检查:WBC7.9×10~9/L,N59％,L41％,胸透两肺心膈正常。腹部站立、仰卧
Liu Moumou, male, 42 years old. Chief complaint: umbilical continuous pain, paroxysmal increase of more than 20 days. Current history: with nausea, vomiting, stomach contents and bile several times, anorexia, weight loss, stool dark brown or yellow, less, emergency admission. Past history of appendicitis more than 2 years, 1 year ago appendectomy. Physical examination: T37 ℃, P84 times / min, R21 beats / min, BP14 / 10kPa. Facial expression pain, fatigue, weight loss, dehydration appearance (Ⅱ °), pale, groin palpable on both sides and several soybean-sized lymph nodes and tenderness, heart, lungs 8cm ~ 10cm incision scars, abdominal tightness, did not touch the obvious mass, full abdominal touch, tenderness and rebound tenderness. Laboratory tests: WBC7.9 × 10 ~ 9 / L, N59%, L41%, chest X-ray lung and diaphragm normal. Abdomen standing, supine