Washington: The Bush administration has ______ for the first time that it may be willing to ______ a multinational force in Iraq to operate under the ______ of the United Nations as long as ______ by an American. The idea was described by Richard L.Armitage, the deputy secretary of state, as just"______" in discussions at the United Nations. It was first ______ publicly last week by Kofi Annan, the United Nations’ secretary general. Mr. Armitage’s remarks, made ______ to regional reporters and released by ______ today, represent ______ in course for the administration, which has until now insisted that all ______ matters in Iraq remain under total American control. Allowing the United Nations ______ would be intended to win the support of the Security Council for ______ authorizing the occupation of the country. In his remarks, Mr. Armitage ______ to discuss the plans ______, saying, "I don’t think it helps to ______ publicly fight now." But he described the arrangement under consideration as "a multinational force ______ "in which "the American would be the U.N. commander." On Monday, Defense Secretary Donald H. Rumsfeld was asked whether he could ______ American troops fighting ______ . His answer: "I think that’s not going to happen." But he went on to rule out only ______ meaning by the United Nations, whose troops wear blue helmets over a peacekeeping force in Iraq.

男性，30岁。餐后1小时突发上腹部剧痛，很快扩散至右下腹，疼痛呈持续性，无放射．伴有恶心、呕吐。发病3小时后来院就诊。体检：血压120/70mmHg。腹平，全腹压痛，反跳痛，肌紧张，以右上腹及中上腹为甚，肝浊音界不清，肠鸣音微弱。

进行立位腹部X线平片检查：未见膈下游离气体。诊断首先应考虑（）

A.胆囊穿孔

B.急性胰腺炎

C.异位急性阑尾炎穿孔

D.急性肠扭转

E.胃十二指肠溃疡穿孔