1病例资料男,73岁。2小时前用力排便后突感下腹部刀割样疼痛,很快波及全腹,进行性加重,伴恶心及呕吐,急诊来我院。查体:体温38℃,脉搏100/min,血压100/60mmHg。腹部稍膨隆,全腹肌紧张,压痛、反跳痛明显,肝浊音界消失,移动性浊音阳性,肠鸣音减弱。X线腹部透视示:双膈下游离气体 1 case information male, 73 years old. 2 hours before the sudden defecation abdomen knife-like pain, quickly spread to the whole abdomen, progressive aggravating, with nausea and vomiting, emergency to our hospital. Physical examination: body temperature 38 ℃, pulse 100 / min, blood pressure 100 / 60mmHg. The abdomen slightly bulging, the whole abdominal muscle tension, tenderness, rebound tenderness obvious, the liver dullness disappeared, mobility dullness positive, bowel sounds weakened. X-ray showed the abdomen: the diaphragm under the free gas