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患者32岁,住院号109221.因下腹部持续性疼痛10天,无排便、无排气4天,以“不完全性肠梗阻”之诊断急诊入院.二年前,行人工流产术同时置T 型节育器一枚.术后一年出现下腹部隐痛,曾多次就诊,当地医院均以“盆腔炎”之诊断对症治疗,但未见明显好转.入院前10天,在某医院取出T 形节育器和金属节育器各一枚,术中经过顺利,无子宫穿孔症状,取环后虽经消炎治疗,腹痛仍未缓解.入院前4天,突然腹痛加剧,伴恶心、呕吐,无排便、无排气.腹部透视见:中腹部有多个液气平面,故以“肠梗阻”收入外科.查体:T37.5℃,P100次/分,Bp13.3/9.3kPa.意识清,痛苦面容,心、肺听诊正常.腹部稍膨隆,未见肠型及蠕动波.肝、脾均未触及,全腹肌紧张,压痛
The patient was 32 years old and hospitalized 109221. The patient was admitted to a diagnostic emergency department of “incomplete ileus” for a continuous 10 days of lower abdominal pain without defecation and for 4 days without extubation. Two years ago, Type IUD .After a year of lower abdominal pain, had multiple visits, the local hospital are “pelvic inflammatory disease” diagnosis of symptomatic treatment, but no significant improvement.On 10 days before admission, T-shaped out of a hospital IUD and IUD each one, intraoperative smooth, no symptoms of uterine perforation, although the ring after anti-inflammatory treatment, abdominal pain has not yet alleviated .4 days before admission, aggravated abdominal pain, with nausea, vomiting, no defecation, No exhaust. Abdominal see: there are multiple liquid-gas level in the abdomen, so the income of “intestinal obstruction” Surgical. Physical examination: T37.5 ℃, P100 beats / min, Bp13.3 / 9.3kPa. Face, heart, lung auscultation normal abdomen slightly bulky, no intestinal and peristaltic waves. Liver, spleen are not touched, the whole abdominal muscle tension, tenderness