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患者女性，５５岁，既往有胆囊炎、胆结石病史十余年，于入院前１周开 始阵发性右上腹疼痛，伴恶心、呕吐不适，在当地医院治疗未见明显好转。入院前１２ ｈ开始 腹痛波及全腹，尤以活动时疼痛明显，伴发热。查体：Ｔ．３８℃，ＢＰ １００／５０ ｍｍＨｇ，神清，精 神?
Female, 55 years old with previous history of cholecystitis and gallstones more than 10 years before onset of paroxysmal right upper quadrant pain with nausea and vomiting 1 week before admission. No significant improvement was seen in the local hospital. The onset of abdominal pain at 12 h before admission affected the entire abdomen, especially when the activity was painful with fever. Physical examination: T 38 ℃, BP 100/50 mmHg, God clear, spirit?