患者37岁,住院号78437。于1991年3月1日因妊娠40周第一胎头盆不称行子宫下段剖宫产术,术中顺利娩出一体重3500g的男活婴。术后第1至3天均有呕吐,逐渐频繁,呕吐物初为胃液及黄绿水,后为胆汁,腹胀痛逐渐加剧。经禁饮食、胃肠减压、补液及液体石蚶灌肠等对症治疗,症状未缓解。3月15日查体:T37.5℃,P84次/分,Bp15/10kPa,急性痛苦面容,心肺正常。腹部极度膨隆,有明显肠型,全腹压痛,无反跳痛,肌张力不高,移动性浊音不明显,肠鸣音减弱。偶有气过水音。化验:Hb83g/L,WBC7.8×10~9/L,血钾3.5mmol/L,钠143.5mmol/L,钙0.22mmol/L,氯98mmol/L。腹平片及钡剂灌肠均提示低位结肠梗阻。于14时20分在硬膜外麻醉下经腹直肌旁切口行剖腹探查术,见腹腔淡黄色透明液体500ml,肠壁水肿充血肥厚,小肠膨 Patient 37 years old, hospital number 78437. On March 1, 1991 due to 40 weeks of pregnancy, the first fetal head of the lower uterine line cesarean section was not performed, the successful delivery of male weight 3500g live baby. 1-3 days after the vomiting, gradually frequent, vomit early as the gastric juice and yellow-green water, after the bile, abdominal pain increased gradually. Prohibited diet, gastrointestinal decompression, fluid replacement and liquid stone emperor enema and other symptomatic treatment, the symptoms did not ease. March 15 examination: T37.5 ℃, P84 times / min, Bp15 / 10kPa, acute pain face, normal heart and lung. Extremely bulging abdomen, with obvious intestinal type, the whole abdominal tenderness, no rebound tenderness, muscle tension is not high, mobility is not obvious dullness, bowel sounds weakened. Occasional gas over the water sound. Assay: Hb83g / L, WBC7.8 × 10 ~ 9 / L, serum potassium 3.5mmol / L, sodium 143.5mmol / L, calcium 0.22mmol / L, chlorine 98mmol / L. Abdominal plain film and barium enema suggest low colon obstruction. At 14:20 under epidural anesthesia by abdominal rectus incision laparotomy, see the abdominal light yellow transparent liquid 500ml, congestion and hypertrophy of the intestinal wall edema, small intestine swelling