双语病例丨小伙茶饭不思，腹痛难忍，入院检查竟是······
2014/12/24 医学生

     1、History 病史

     A previously healthy 23-year-old male presented to the emergency room with a 3-day history of anorexia, nausea and abdominal pain. The pain was gradual in onset, visceral in nature and epigastric in location. Medical help was sought when antacids brought no relief and the pain localized in the right lower abdominal quadrant.

     急诊室有一名平素体健的男性，23岁，出现厌食症状3天，伴有恶心和腹痛。在上腹部位置出现渐进性内脏痛。使用抗酸剂无法缓解，且出现局限性右下腹痛，遂来我院就诊。

     Vital signs included temperature 38 C, pulse 80 per minute and blood pressure 120/80. The patient was a well developed, mild dehydrated man in moderate abdominal distress. The pharynx was unremarkable and the chest was clear. Bowel sounds were absent. The abdomen was rigid with marked rebound tenderness in the lower quadrants. No rectal tenderness was noted.

     生命体征：体温38℃，脉搏每分钟80次，血压120/80。病人发育正常，轻度脱水伴中度腹部不适。咽部和肺部未见明显阳性症状。肠鸣音消失。下腹部有明显压痛和反跳痛。直肠指检未见明显异常。

     2、Therapy 治疗

     An appendectomy was performed.

     行阑尾切除术。

    

     The gross appearance of the cut appendix

     术中摘除的阑尾大体外观

    

     A normal appendix as control.

     一个正常的阑尾作为对照。

     Comparing with both,What differences are there?

     比较两个，有什么不同？

     3、Pathology 病理

    

     Under light microscophy, there is a diffuse inflammatory infiltrates in the whole wall of appendix. Note the congestion and exudates in the serosa.

     光学显微镜可见弥漫性炎性浸润整个阑尾壁。注意浆膜充血和分泌物。

    

     Under the high power field there is a neutrophils predominant

     infiltrate in the lumen and mucosa of appendix.

     在高倍视野下可见管腔黏膜渗透的以中性粒细胞为主的阑尾。

     4、What is your diagnosis?

     你的诊断是什么呢？

     Discussion 讨论

     1. Histological diagnostic criteria

     2. Complications

     3. The clinicopathologic correlations

     4. Why he has fever?

     5. What could be found in his blood tests?

     --------------------------------------------------------

     1、 组织学诊断标准。

     2、 并发症。

     3、 临床病理的相关性。

     4、 他为什么会发热？

     5、 在他的血液测试中能得知什么信息？

     翻译：莫海韵

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