外科學(xué)急性腹膜炎英語

AcuteAcuteSuppurativeDepartmentofVascularSurgeryTheSecondAffiliatedHospitalChongqingMedical TangAnatomyof ---parietal---visceral inmanandwomanLesser DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical3Departmentof3DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalNerveParietal y→sharp※Peritoneal﹡Rebound

VisceralAutomaticpoorlylocalizedpain→Dull DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalStructureandFunctionof DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalDefinitionofClassificationofBacterialandnonbacterialAcute,subacuteandchronicPrimaryandsecondaryDiffuseandlocal DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPrimaryWhatisprimaryperitonitisDiffusebacterialinfectionwithoutanapparentintraabdominalsourceofinfectionOrganismsinprimary ococcus,hemolyticstreptococcus,Ecoli, DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPrimaryRoutesofbacterialbloodstreamascendinginfectiondirectbacterialtransmural DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalSecondaryWhatissecondaryperitonitisOrganismsinsecondaryperitonitisEAnaerobicbacteroidProteusspecies DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalSecondary1VisceraChemicalPeritonitisBacterialPeritonitis2、Infltion3、4、5、Anastomosis DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalDepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical CommonCausesof DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalCase DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical

急性腹膜腹膜水腫、滲液纖維蛋白毒毒素吸

細胞外

、腸麻腸內(nèi)積液肺肺交換量抗利尿激素 尿量 心排出量抗利尿激素尿量心排出量組織缺氧周圍血周圍血管收縮休代謝性酸 DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalClinicalAbdominalNausea、ChangesoftemperatureandSystemic DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalAbdominalAbdominalMuscleSpasm DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalAbdominalBowelRectal&VaginalPelvicInfectionPelvicAbscess DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalAccessoryWBC↑andleukocytosiswithleftshiftof inAirbeneaththeAbdominal DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalDepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical Abdominal病 外觀、嗅 顯微鏡檢

血性，無臭，淀粉酶＞1500Somogy

DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPeritonealMuscleSpasmAccessory DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalNonoperative1、Posturesemisupineposition2、Fasting,Gastrointestinalpression3、FluidandElectrolyte4、AntibioticTherapy5、Nutritional DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalOperativeIndications1、6~8hnonoperativetreatmentinvalid2、Seriousprimarydisease3、Severeinfectionandparalyticileus4、Unclearcauseof DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalOperativeRemovingtheExplorativeCleaningthePostoperative DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPeritonealSubphrenicAbscessPelvicAbscessInterintestinalAbscess DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalSubphrenicClinical inedPersistentfever&abdominalpainreoccurseveraldaysafterrecovery★acute★infectionofintra-abdominal★abdominal DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical1、PercutaneousAbscess 2、OpenTransabdominalincisionandrelativelylowspaceinsupinepositionsemi-supineposition DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPelvicClinicalToxicsymptomsIrritationoftherectumRectaltenesmusUrinaryirritation DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalPelvicRectal，Vaginaltenderness&US&antibiotic,hotsitebath,warmsalinePelvic DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalDepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedical interintestinalSingleAbscessMultipleAbscesstoxicFever,pain,abdominaldistentionileus&sometimes palpableintestinalobstructiondueto DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalInterintestinalUS&surgical DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalDepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalCase ysisofaMedicalAmalepatientof35wasadmitted,com iningofintermittentabdominalpainfor10yearswhichwasmoremarkedinthepast6hours.Tenyearsago,hebegantohaveepisodesofpainovertheepigastriumpersistedfordaysorevenweeksateachtime&oftenassociatedwithdietaryindiscretion.Sometimeshehadnocturnalabdominalpain,severeenoughtowakeuphimfromsleepattimes,butbothfood&alkalinemedicinesmayrelievethepain.Suchepisodesoccurredalmostonceayear.6hoursago,hesuddenlysufferedfromsevereupperabdominalpainwhichspreadtothewholeabdomen,paniedwithnausea&vomiting. DepartmentofVascularSurgery,theSecondAffiliatedHospital,ChongqingMedicalP.E:T38.5℃,P105/min,R21/min,BPNormallydeveloped&mentallyclearbutacu yill-looking.Nojaundiceonskinorsclerae.Superficiallymphnodesnotpalpable.Necksoftandsupple.Tracheainmidline.Thyroidnotenlarged.Heart&lungsnotabnormal.Abdomenflat&board-likerigidwithmarkedtenderness&reboundtendernessespeciallyinepigastrium,togetherwithdecreasedliverdullness.Spleennotpalpable.Bowelsoundsdecreased.Nopathologicalreflexesfound.X-ray&Laboratoryfindings airunder2.Bloodpicture:Hb98g/l,WBC15.6×109/LN0.89,Discussthediagnosi