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【单选题】
患者女性，47岁，突发左上腹部刀割样剧痛5小时，伴恶心、呕吐来院急诊。体检：体温36.1℃，血压85／55mmHg，脉搏116次／分钟。患者呈急性面容，表情痛苦，蜷曲位、不愿移动。腹式呼吸减弱。全腹有明显的压痛和反跳痛。以上腹部最为明显，腹肌紧张，呈“木板样”，肝浊音界缩小，肠鸣音消失。既往有胃溃疡病史。首先考虑的疾病是A.
急性胆囊炎穿孔
B.
胃溃疡急性穿孔
C.
坏疽性阑尾炎
D.
绞窄性肠梗阻
E.
急性胰腺炎
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