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患者25岁(病案号149904)。因突发性下腹疼痛4小时,伴头晕、恶心、呕吐、腹泻四次,为稀血便,有“里急后重”感,无寒战、高热。于1990年8月29日到我院肠道门诊就诊。查体:血压11.0/7.0kPa。WBC16900/mm~3,Hb9.6g/dl。以“中毒性菌痢”收入传染科。住院后病人面色苍白,腹痛加重,血压持续下降至6～6.5/0kPa,Hb5.2g/dl,考虑有内出血。请妇科会诊,追问病史,谓剖宫产术后1年,带节育环3个月。前次月经为7月25日,入院前一天阴道流血,似月经量。检查:患者颜面、口唇、甲床苍白。脉细弱,160次/分。心肺未见明显异常。腹部膨隆,肝、脾未能及。妇科检查:阴道有暗红色血液,后穹窿饱满,有触痛。宫颈光滑,有少
Patient 25 years old (case number 149904). Due to sudden abdominal pain for 4 hours, with dizziness, nausea, vomiting, diarrhea four times for the dilute blood will have a “tenesmus” flu, no chills, fever. In August 29, 1990 to our hospital intestinal clinic. Physical examination: blood pressure 11.0 / 7.0kPa. WBC16900 / mm ~ 3, Hb9.6g / dl. To “toxic bacillary dysentery” income infectious diseases. After hospitalized patients pale, abdominal pain increased, blood pressure continued to decline to 6 ~ 6.5 / 0kPa, Hb5.2g / dl, consider the internal bleeding. Please gynecological consultation, medical history, that 1 year after cesarean section, with birth control ring 3 months. The last menstruation for July 25, vaginal bleeding the day before admission, like menstruation. Check: The patient’s face, lips, nail bed pale. Pulse thin, 160 beats / min. Heart and lung no obvious abnormalities. Abdominal bulging, liver and spleen failed and. Gynecological examination: dark red blood vagina, after the dome full, tenderness. Cervical smooth, with less