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例1女,55岁,因意识不清10分钟伴大汗急诊入院。查体:血压8.0/5.3 kPa,脉搏102次/分,意识清楚,面色苍白,四肢湿冷,心肺正常,上腹压痛,无肌紧张及反跳痛,肝脾不大,移动性浊音(±)。实验室检查:血糖19.62mmol/L,CO_2CP 15mmol/L,K~+ 2.0mmol/L,Na~+ 127mmol/L,Cl~- 96.5mmol/L,Ca~(++)1.724mmol/L,血常规、肝功、肾功、大便、尿常规、尿糖、尿酮均正常。拟诊为糖尿病,给予胰岛素及纠正电解质失衡和抗休克等治疗。入院第二天全腹压痛,右下腹肌紧张,反跳痛。腹部B超示胰头显示欠清,体厚2.2cm,尾厚1.7cm,实质回声欠均匀,腹腔中等量积液。血淀粉酶7792.5U/L(正常值800～1800U/
Example 1 Female, 55 years old, due to unconsciousness 10 minutes with sweat emergency admission. Examination: blood pressure 8.0 / 5.3 kPa, pulse 102 beats / min, clear consciousness, pale, limbs cold and wet, normal heart and lungs, abdominal tenderness, muscle tension and rebound tenderness, . Laboratory tests: blood glucose 19.62mmol / L, CO_2CP 15mmol / L, K ~ + 2.0mmol / L, Na ~ + 127mmol / L, Cl ~ - 96.5mmol / L, Ca ~ (++) Conventional, liver function, kidney function, stool, urine, urine, urine ketone are normal. To be diagnosed as diabetes, given insulin and electrolyte imbalance and anti-shock treatment. Full abdominal pressure on admission the next day, right lower quadrant muscle tension, rebound tenderness. Abdominal B showed pancreatic headache show less, body thickness 2.2cm, tail thickness 1.7cm, the real echo less uniform, the average amount of intraperitoneal effusion. Blood amylase 7792.5U / L (normal 800 ~ 1800U /