男性，38岁。因胃溃疡行毕Ⅱ式胃大部切除术后第3天，突感右上腹剧烈疼痛。查体：右上腹压痛（+），全腹肌紧张。最可能的诊断是（）
A.急性胆囊炎
B.急性胰腺炎
C.胃肠吻合口破裂
D.十二指肠残端破裂
E.腹内疝形成
参考答案：D
解析：毕Ⅱ式胃大部切除术后早期发生右上腹剧烈疼痛，迅速蔓延至全腹，最有可能的原因是由于十二指肠残端破裂引起。
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| A businesswoman got into a taxi in midtown. As it was the rush hour and she was in a__1__to catch a train, she__2__a quick way to reach it. "I have been a taxi driver for 15 years!" the driver said__3__. "You don't think I know the best way to go?" The woman tried to explain that she hadn't__4__to annoy him, but the driver kept__5__. She finally realized that he was too annoyed to be__6__, so she changed her__7__. "You know, you are right, " she told him. "It must seem__8__for me not to think you know the best way__9__the city." 10 , the driver glanced at his 11 in the rearview mirror, turned down the street she wanted and got her to the train on time. "He didn't say another word the rest of the ride, "she said. " 12 I got out and paid him. Then he thanked me." When you find yourself 13 with people like the taxi driver, you will always try to 14 your idea. It can lead to longer arguments, lose job chances or 15 marriages. I have discovered one simple 16 extremely unlikely method that can prevent the disagreement or other difficult situations from 17 in a disaster. The 18 is to put yourself in the other person's shoes and look for the 19 in what that person is saying. Find a way to 20 , and the result may surprise you. | ||||
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