外科学教学课件：急腹症.ppt

有志做普外大夫的学生联系我 罗福文 周二全天专家门诊 大医二院普外五病房（急腹症）QQ1722818415 微信：luofuwen2011 微博：WC里的石头 email：1722818415@ fuwenluo@ 1perforation Ulcer history Sudden, severe , epigastric pain Obvious peritonitis Diminution of liver dullness Free subphrenic gas perforation 2Acute cholecystitis Fatty food Severe epigastric colic pain Referring to right back pain Tenderness in right upper quandrant B-us shows enlargement of gall bladder Gall bladder Stone 2ASOCacute suppurative obstructive cholangitis 痛pain 热fever 黄jaundice 休克shock 四联症 精神症状psycholigical symptoms Charcot’s triad Renold’s pentalogy 五联症 2AOSC 3 SAP（ 重症胰腺炎） Alchol and fatty food intake Severe persistant pain Amylase level elevated (Amy) CT P enlargement, necrosis, exudation Suppurative fluid around pancrea Necrotic pancreatic tissue 4APP Epgastric pain shfting to the right lower quadrant Tenderness in the right lower quadrant Acute abodomen */45 open your eyes open your eyes Acute abodomen * 5 Acute bowel obstruction Pain 　 vomit 　higher obstruction Distention 　lower obstruction Obstipation tenderness, peritonitis? Active bowel sound Xray gas-fluid level Acute abodomen */45 Luo fuwen Acute abodomen */45 Acute abodomen * Gynecological diseases Acute pelvic Infection Young, fever, pain Tenderness in the lower wall, Vaginal discharge increased Smear gram negative diplococcus Torsion of ovary tumor pedicle Pelvic Bus uterus, ovary Sudden onset of pain, severe Ectopic pain　　HCG, menostasis Yellow body rupture midcycle Acute abodomen */45 App and yellow body rupture Acute abodomen * 教训 教训 教训 教训 Torsion of ovary tumor pedicle Torsion of ovary tumor pedicle 内科病也要命 心梗？ 肺炎 糖尿病 过敏？ 肝硬化 病毒感染（带状疱疹，流行性出血热） 肠炎？ 疱疹误诊急腹症 Questions Common acute abdomen reasons how to differentiate acute abdomen? Acute abodomen */45 how to differentiate acute abdomen? depends on all your experience, your lessons or even disasters Acute abdomen急腹症 Properite