试题与答案

男性，17岁，7小时前不慎右上腹部撞在栏杆上，5小时前出现腹痛，伴消化道症状。查体：

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题型：单项选择题 共用题干题

题目：

男性，17岁，7小时前不慎右上腹部撞在栏杆上，5小时前出现腹痛，伴消化道症状。查体：神清，血压10/6.0kPa（75/45mmHg），全腹压痛，伴腹膜刺激征，腹部叩诊浊音，肝区叩痛（+）。

考虑可能诊断为（）。

A.脾破裂

B.小肠破裂

C.肠系膜破裂

D.肝破裂

E.后腹膜血肿

答案：

参考答案：D

解析：

患者右上腹部撞伤后出现腹痛，伴消化道症状，全腹压痛，伴腹膜刺激征，腹部叩诊浊音，肝区叩痛（+）提示肝破裂可能性大。肝破裂损伤主要表现为腹腔内或腹膜后出血，患者血压10/6.0kPa（75/45mmHg）低，休克，当肝破裂伴有胆管断裂时，胆汁刺激腹膜，也可表现出腹膜刺激症。

考点：泌尿外科学(医学高级)泌尿外科综合练习泌尿外科综合练习题库
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