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1 病历摘要例1,女,55例。2天前因大便秘结、排便困难伴有间歇性脐周隐痛,于当日下午用力排便时腹痛突然加重,呈持续性,放射至肛门及会阴部并很快累及全腹,伴大汗,四肢冷,恶心呕吐数次入院。查体 P96次/min,BP10/6kPa,而色苍白,腹压痛,肌紧张,肠鸣音弱,移动性浊音(+),腹穿见不凝血。有慢支、肺气肿病史。血 RT:WBC5.1×10~9/L,NO.88,Hb98g/L。B 超示腹内大量无回声暗区内有光点瞟游。术中见腹内多量血块,积血2000ml,回肠末端距回盲部9cm 处肠系膜13cmx6cm×4cm 大小血肿,活动出血。切除该段肠管,对端吻合。病理示小肠系膜海绵状血管瘤破裂出血。
1 case summary 1 cases, female, 55 cases. 2 days ago due to constipation, defecation accompanied by intermittent umbilical pain, abdominal pain in the afternoon when forced defecation suddenly increased, was persistent, radiation to the anus and perineum and soon affected the whole abdomen, with sweat, limbs Cold, nausea and vomiting admitted several times. Physical examination P96 times / min, BP10 / 6kPa, and pale color, abdominal tenderness, muscle tension, bowel sounds weak, shifting dullness (+), abdominal see without coagulation. A chronic bronchitis, emphysema history. Blood RT: WBC 5.1 × 10 ~ 9 / L, NO.88, Hb98g / L. B ultrasound showed a large number of anechoic dark area within the light point Tour. Intraoperative intraoperative see a large number of blood clots, hemorrhage 2000ml, ileum from the ileocecal end of 9cm Department of mesentery 13cmx6cm × 4cm size hematoma, bleeding activity. Excision of the segment of bowel, anastomosis. Pathology of small intestinal cavernous hemangioma rupture bleeding.