男性，46岁。急性阑尾炎伴阑尾穿孔手术 后持续发热半个月。右上腹及右肋缘下疼 痛，并向右肩部放射。腹部X线平片：右 膈肌膨隆，可见局限性液平。X线胸片：右侧胸腔积液。根据患者情况，首先考虑的术后并发症是

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