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现将1978年10月～1995年10月手术证实共误诊68例,做一临床分析。 与外伤相关的急腹症21例:①结肠穿孔6例,4例为刀伤腰腹部,2例为木棒戳伤。②肝破裂4例,有胸腹外伤史,贫血,唯一体征是肝脾区叩击痛是诊断的依据。③十二指肠破裂3例,有背部外伤史,腹膜炎、腹穿为黄绿色漏出液。④脾包膜下破裂4例,左季肋部或左背部外伤.病人轻度贫血,血压尚好。⑤膀胱破裂4例.下腹外伤,腹痛无尿,从导尿管注入200ml生理盐水抽不出液体,可确诊腹膜外膀胱破裂。 疾病引起的急腹症47例:①妇科急腹症17例,均误诊为阑尾炎、化脓性盆腔炎7例.卵巢囊肿扭转3例,宫外孕5例,右侧输卵管滤泡破裂2例。②儿科急腹症12例:肠系膜淋巴结炎5例,误诊勾急性阑尾炎、肠套迭复位后再套迭4例,粘连性肠梗阻3例。③晚期胃穿孔4例。④腹茧症2例,此病为罕见疾病,本院所遇到2例均误诊。⑤老年人肠梗阻4例。⑥手术有关的肠梗阻4例。⑦肠系膜淋巴肉瘤4例。 总之,急腹症的诊断应根据与疾病有关的年龄、性别、病史、与外伤有关的性质、部位、内脏位置及解
Now from October 1978 to October 1995 confirmed a total of 68 cases of misdiagnosis, do a clinical analysis. Acute abdomen associated with trauma in 21 cases: ① colon perforation in 6 cases, 4 cases of stab wounds waist and abdomen, 2 cases of stick injury. ② liver rupture in 4 cases, a history of chest and abdomen trauma, anemia, the only signs of peristalsis in the liver and spleen area is the basis of diagnosis. ③ duodenal rupture in 3 cases, a history of trauma back, peritonitis, abdominal wear yellowish green liquid leakage. ④ splenic capsule rupture in 4 cases, the left quarter of the ribs or left back trauma patients with mild anemia, blood pressure is still good. ⑤ Bladder rupture in 4. Lower abdominal trauma, abdominal pain without urine, 200ml of saline injected from the catheter can not pumped liquid, can be diagnosed with extraperitoneal bladder rupture. Acute abdomen caused by disease in 47 cases: ① 17 cases of gynecologic acute abdomen, were misdiagnosed as appendicitis, suppurative pelvic inflammatory disease in 7. 3 cases of ovarian cyst torsion, 5 cases of ectopic pregnancy, right tubal follicular rupture in 2 cases. ② 12 cases of pediatric acute abdomen: mesenteric lymphadenitis in 5 cases, misdiagnosis of acute appendicitis, intussusception and reposition after nesting in 4 cases, 3 cases of adhesive intestinal obstruction. ③ advanced gastric perforation in 4 cases. ④ cocoon 2 cases, the disease is a rare disease, the hospital encountered two cases were misdiagnosed. ⑤ 4 cases of intestinal obstruction in the elderly. ⑥ surgery-related intestinal obstruction in 4 cases. ⑦ mesenteric lymphosarcoma in 4 cases. In summary, the diagnosis of acute abdomen should be based on the age, sex, medical history, traumatic related nature, location, internal organs location and solution