外科学_小肠疾病

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• 41A 70-year-old woman has nausea， vom iting， abdominal distention， and episodic，crampy midabdominal pain. She has no history of previous surgery but has a long history of cholelithiasis fo r w hich she has refused surgery.  H er abdominal radiograph reveals aspherical density in the right low er quadrant. Correct treatm ent should consist of

  A.Ileocolectomy

  B.Cholecystectomy

  C.Ueotomy and extraction

  D.Nasogastric tube decompression

  E.Intravenous antibiotics

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• 42A 28-year-old previously healthy woman arrives in the emergency room complai­ning of 24h of anorexia and nausea and low er abdominal pain that is more intense in the right low er quadrant than elsewhere. On exam ination she has peritoneal signs o f the right low er quadrant and a rectal tem perature of 38. 38℃ (101. 8 。F ). At exploration throughincision of the right lower quadrant，she is found to have a small?contained perforation of acecal diverticulum . Which of the follow ing statements re

  A.Cecal diverticula are acquired disorders

  B.Cecal diverticula are usually multiple

  C.Cecal diverticula are mucosal herniations through the muscularis propria

  D.Diverticulectomy，closure of the cecal defect，and appendectomy may be indicated

  E.A nileocolectomy is indicated even with well-localized inflam mation

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• 43男性，40岁，因肠梗阻2天急诊收住入院，剖腹探查发现结肠、小肠高度扩张，盆底有数枚。2cm左右的结节，直肠前壁于腹膜返折处有一肿块，占肠管3/4，侵及全层，最佳的手术方法为

  A.Miles手术

  B.Dixon手术

  C.Bacon手术

  D.Hartmann手术

  E.Drhamel手术

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• 44男性，60岁，因便血2周来院就诊。体格检查一般情况良好，腹部无肿块，直肠指诊未及肿块，乙状结肠镜检查发现距肛缘12cm处一肿块，呈菜花状，2cm×2cm大小。最佳的手术方法为

  A.Miles手术

  B.Dixon手术

  C.Bacon手术

  D.Hartmann手术

  E.Drhamel手术

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• 45乙状结肠扭转

  A.X线片见气液平面多个，呈阶梯状排列，结肠无胀气

  B.X线片见气液平面多个，结肠普遍胀气

  C.X线片见突出胀气肠袢，呈“咖啡豆”样改变

  D.钡剂灌肠呈“鸟嘴”形

  E.钡剂灌肠呈杯状充盈缺损

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• 46肠套叠

  A.X线片见气液平面多个，呈阶梯状排列，结肠无胀气

  B.X线片见气液平面多个，结肠普遍胀气

  C.X线片见突出胀气肠袢，呈“咖啡豆”样改变

  D.钡剂灌肠呈“鸟嘴”形

  E.钡剂灌肠呈杯状充盈缺损

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• 47小肠扭转

  A.X线片见气液平面多个，呈阶梯状排列，结肠无胀气

  B.X线片见气液平面多个，结肠普遍胀气

  C.X线片见突出胀气肠袢，呈“咖啡豆”样改变

  D.钡剂灌肠呈“鸟嘴”形

  E.钡剂灌肠呈杯状充盈缺损

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• 48麻痹性肠梗阻

  A.X线片见气液平面多个，呈阶梯状排列，结肠无胀气

  B.X线片见气液平面多个，结肠普遍胀气

  C.X线片见突出胀气肠袢，呈“咖啡豆”样改变

  D.钡剂灌肠呈“鸟嘴”形

  E.钡剂灌肠呈杯状充盈缺损

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• 49乙状结肠扭转的X线

  A.“杯口”征

  B.“鸟嘴”征

  C.“阶梯状”排列

  D.线样征

  E.充盈缺损

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• 50回-结肠套叠的X线

  A.“杯口”征

  B.“鸟嘴”征

  C.“阶梯状”排列

  D.线样征

  E.充盈缺损

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