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患者25岁,住院号84374。产后26天,右下腹疼痛半月,加重一天于1984年1月23日入院。1983年12月27日头位正常产分娩一女活婴,胎盘胎膜剥离完整,出血约300ml,用催产素后血量减少。半月后开始发冷发热,右下腹疼痛伴恶心呕吐,对症治疗后好转,但右下腹仍有隐痛,如针刺样呈持续性,有阵发性加剧,门诊以“阑尾炎穿孔弥漫性腹膜炎”收入院。查体:T39℃,Bp80/50mmHg。急性痛苦病容,被迫体位,轻度贫血貌,神志清,全下腹有肌卫,压痛、反跳痛明显,无移动性浊音。妇科检查:子宫水平位,大小触不清,有压痛,活动差。右侧附件区有6×5×4cm 肿块,质硬、有压痛,不活动。后穹窿轻度饱满,穿刺为脓性液体。白细胞14.2×10~9/L,
Patient 25 years old, hospital number 84374. Postpartum 26 days, right lower quadrant pain half a month, aggravating one day in January 23, 1984 admission. December 27, 1983 head normal delivery of a female living baby, placental membranes stripped complete, bleeding about 300ml, with oxytocin blood volume decreased. Half a month after onset of chills and fever, right lower quadrant pain with nausea and vomiting, symptomatic improvement after treatment, but there is still pain in the right lower quadrant, such as acupuncture was persistent, paroxysmal exacerbations, outpatient “perforation perforation diffuse peritonitis” income hospital. Physical examination: T39 ℃, Bp80 / 50mmHg. Acute pain and sickness, was forced to position, mild anemia appearance, clear consciousness, the lower abdomen with myo-Wei, tenderness, rebound tenderness obvious, no mobility dullness. Gynecological examination: Uterine level, the size of palpable, tenderness, poor activity. The right side of the annex area 6 × 5 × 4cm mass, hard, tenderness, inactivity. Posterior fornix slightly full, puncture for purulent liquid. Leukocytes 14.2 × 10 ~ 9 / L,