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患者26岁,住院号3049.初孕34孕周,上腹部疼痛,恶心呕吐8小时,於1981年12月4日7时入院.既往健康,孕期经过正常.12月3日23时开始上腹部疼痛,恶心,呕吐4～5次,为胃内容,腹泻一次为黄色水样便,伴有阵发性腹部坠痛.检查:T38℃,P72次/分,Bp18.7/13.3 kPa.心肺正常.上腹软无压痛,肝脾未触及.无水肿,宫底脐上4横指,枕右前位,胎心良好,无明显宫缩,宫颈未消失,宫口未开.Hb140g/L,WBC9.5×10~9/L.诊断:初孕妊娠34周;妊娠高血压;先兆早产;急性胃炎.给予镇静、降庄剂及阿托品和黄体酮等,上腹部疼痛缓解能进食.5日15时饭后不久突然上腹剧痛,伴有恶心呕吐,呕吐物均为食物,烦躁不安,大汗淋漓.查体:上腹软,心窝部有压痛,无反跳痛.Bp17.3/120kPa 用阿托品未缓解,疑急性肠炎、急性胰腺炎
The patient was 26 years old and hospitalized 3049. The first trimester of 34 weeks gestation, upper abdominal pain, nausea and vomiting for 8 hours, at 7:00 on December 4, 1981 was admitted .Previous health, normal pregnancy .December 3 at 23 o’clock start upper abdomen Pain, nausea, vomiting 4 to 5 times for the stomach contents, diarrhea, once the yellow watery stools, accompanied by paroxysmal abdominal pain. Check: T38 ℃, P72 beats / min, Bp18.7 / 13.3 kPa. No abdominal pain, no contact with liver and spleen. No edema, 4 at the uterus on the uterus transverse, occipital right anterior, fetal heart rate was good, no significant contractions, the cervix did not disappear, cervix is not open .Hb140g / L, WBC9 .5 × 10 ~ 9 / L. Diagnosis: first trimester of pregnancy 34 weeks; pregnancy-induced hypertension; threatened premature delivery; acute gastritis. Given sedation, reducing agent and atropine and progesterone, upper abdominal pain relief can eat .5 15 Shortly after meal suddenly abdominal pain, accompanied by nausea and vomiting, vomit food, restlessness, sweating .Check the body: upper abdomen soft, heart Ministry of tenderness, no rebound pain .Bp17.3 / 120kPa Atropine did not relieve, suspected acute enteritis, acute pancreatitis