患者男性，１８岁。上腹部突发性刀割样剧痛并转移到右下腹２小时就诊。查体：表情痛苦，平卧不敢翻动体位，全腹有压痛、反跳痛、肌紧张，以上腹部最明显，肠鸣音消失，肝浊音界缩小。Ｂ超检查：肝胆胰未见异常，平卧位肝前间隙可见大量游离气体（右图，箭头所示），致使... Patient male, 18 years old. Sudden upper abdomen knife-like pain and transferred to the right lower quadrant 2 hours treatment. Physical examination: expression of pain, supine can not flip body position, the whole abdomen with tenderness, rebound tenderness, muscle tension, the most obvious abdomen, bowel sounds disappear, liver dullness narrowed. B-ultrasound: no abnormal hepatobiliary and pancreas, supine position a large amount of pre-hepatic clearance of free gas (right, arrow), resulting in ...