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男,64岁。餐后突发持续性上腹绞痛1天,向右腰背放射,伴恶心、呕吐胃内容物、腹胀。查体:T38.8℃,HR110次/分,BP90/50mmHg,腹膨隆,上腹压痛明显,无明显反跳痛及肌紧张,移动性浊音可疑,肠鸣音减弱。化验检查:WBC19×10
9
/L,血淀粉酶125U/L,Na
+
135mmol/L,K
+
3.5mmol/L,Ca
2+
1.75mmol/L,Glu13mmol/L。腹部立位片见脐周、左上腹肠腔积气。急诊应选择的检查是()
A . 胃镜
B . 腹部超声
C . 上消化道钡餐
D . 诊断性腹穿
E . 肠系膜上动脉造影
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