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老年人结肠癌有时因漏、误诊 ,或仅单纯行阑尾切除术而贻误结肠癌的手术时机。为减少漏、误诊 ,将我院 1990~ 2 0 0 0年收治的老年人结肠癌误诊为急性阑尾炎 2 4例的原因分析如下。1 临床资料1 1 一般情况 男 17例 ,女 7例 ;年龄 5 0~ 6 5岁 ,平均 5 7 5岁。1 2 误诊情况 术前诊断为急性阑尾炎 8例 ,术中发现为结肠癌 ,行右半结肠切除术 6例 ,因腹腔感染严重、放置引流、关腹、术后控制腹腔内炎症后二期手术根治 2例。第 1次因急性阑尾炎表现而行阑尾切除术 ,术后复诊时发现结肠癌 16例 ,其中以发热 ,右下腹肿块就诊怀疑阑尾炎 ,切除… 相似文献
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急性阑尾炎是外科常见的急腹症,其典型症状之一为转移性右下腹疼痛,症状不典型患者容易发生误诊误治.该病可导致腹膜炎、阑尾穿孔、脓毒症等急慢性并发症,严重者危及生命.该文报告了新冠疫情防控期间武警某部士兵急性阑尾炎误诊1例.该例早期症状为腹痛、腹泻、呕吐等,转移性右下腹疼痛不明显,加之基层门诊医疗条件有限,初诊误诊为急性胃... 相似文献
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阑尾炎是外科常见病,阑尾切除术是此病的常规治疗方法,微创外科要求最小的手术切口,最轻的全身反应和最小的疤痕愈合[1]。腹腔镜下阑尾切除术是微创外科的一种手术方式。此外,小切口阑尾切除术也具有积极的临床意义。1对象和方法1.1对象自2004年1月~2005年1月,行阑尾切除术患者(不包括剖腹探查阑尾切除术)369例,其中211例采用小切口,同期158例行传统的经典阑尾切除术作为对照组。全部病例均有转移性或不转移性右下腹疼痛,男232例,女137例,年龄最小5岁,最大65岁,平均30.1岁,术后病理证实慢性阑尾炎201例,急性阑尾炎168例,其中急性单纯性阑尾… 相似文献
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急性阑尾炎为最常见的急腹症 ,正常阑尾超声检查多难以显示 ,但阑尾炎性肿大明显或有积液 ,超声亦能发现病变阑尾的图像。本文通过对急性腹痛病人在B超探查时 ,腹部声像图异常表现而疑诊为急性阑尾炎的病例 ,经与临床资料对比证实为急性阑尾炎的 5 0例 ,分析探讨 ,旨在提高B超对本病的诊断水平。1 材料与方法 搜集我院 2 0 0 0年 1月~ 2 0 0 2年 1月间因腹痛或转移性右下腹痛 ,伴恶心呕吐、发热病人经B超检查诊断为急性阑尾炎的病例 5 0例 ,其中男 35例 ,女 15例 ,年龄 17~ 70岁。手术证实 38例 ,临床保守治疗后确诊 11例 ,误诊 1例… 相似文献
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文新瑜 《中国航天工业医药》2010,(9):99-101
急性阑尾炎是外科常见病,是最多见的急腹症,有时因临床表现多变易被误诊[1],可发生于任何年龄阶段,及时、正确的诊断对于临床治疗方案的选择具有重要意义,对急性单纯性、化脓性及坏疽性阑尾炎应及早手术,而阑尾周围脓肿临床上多采用以抗感染治疗为主的非手术治疗,病变局限后再进行手术。近年随着超声检查的广泛应用, 相似文献
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阑尾切除术微创切口的应用 总被引:2,自引:0,他引:2
急性阑尾炎手术如何减少副损伤 ,降低手术并发症是阑尾切除术的基本要求之一。我院于 1999年开始对阑尾切除术采用微创切口 ,取得了满意效果。1 对象和方法1 1 对象1.1 1 微创组 用微创切口行阑尾切除术 2 39例 ,男 15 6例 ,女 83例 ;年龄 2~ 76岁 ,平均 2 7.2岁。急性阑尾炎 2 16例 ,慢性阑尾炎 2 3例。病理诊断 :急性单纯性阑尾炎 35例 ,急性化脓性阑尾炎 14 6例 ,急性坏疽性阑尾炎 4 0例。慢性阑尾炎 18例。1.1 2 对照组 用麦氏切口行阑尾切除术 2 30例 ,男 132例 ,女 98例 ;年龄 5~ 73岁 ,平均 2 8.1岁。急性阑尾炎 2 0 9例 ,慢… 相似文献
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Bai Jin Tao Sun Bing Li Xu Feng Han Feng Yang 《Journal of the Belgian Society of Radiology》2022,106(1)
Magnetic resonance images (MRI) of migrated nucleus pulposus after collagenase treatment of lumbar disc herniation are rarely published. Here, we describe a 65-year-old woman with L5-S1 intervertebral disc herniation on the rear left. The patient was treated with a lumbar disc collagenase injection, and the pain was relieved. Two weeks later, the patient suddenly developed pain again after engaging in weight-bearing activity. Lumbar MRI showed a nodule in the spinal canal at the L5-S1 level. The patient underwent surgical treatment two days later. Pathology showed that the nodule was nucleus pulposus tissue.Teaching point: It is important to understanding the MR manifestations of migrated nucleus pulposus after collagenase treatment to prevent such misdiagnosis. 相似文献
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阑尾炎的MDCT诊断误区 总被引:4,自引:0,他引:4
目的探讨如何最大限度地降低阑尾炎的多排螺旋CT(MDCT)误诊率,做到阑尾炎早诊断、早治疗,减低延迟治疗率和阴性切除率。资料与方法回顾性分析76例阑尾炎和59例非阑尾炎患者的MDCT影像和临床资料,对误诊的原因进行总结。结果 76例阑尾炎患者中诊断为正常阑尾5例,漏诊率6.6%。59例非阑尾炎患者中误诊为阑尾炎6例,误诊率10.2%。阑尾炎的MDCT诊断误区可以分为四类:炎性阑尾表现正常(3例),阑尾显示不清(2例),类似阑尾炎的疾病(4例),类似阑尾的组织(2例)。结论熟悉阑尾炎的MDCT征象,完善检查方法并密切结合临床资料可以提高对阑尾炎的诊断准确率。 相似文献
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胸部刀刃穿透伤112例临床分析 总被引:10,自引:1,他引:9
目的 总结胸部刀刃穿透伤临床特点、诊断及处理的临床经验。方法 对1995~1999年我科收治的112例胸部刀刃穿透伤临床诊治情况进行分析。结果 早期明确诊断109例,漏诊3例。闭式引流98例、胸穿19例,手术治疗52例,其中开胸27例、开腹25例。治愈105例,死亡5例。结论(1)胸部刀刃穿透伤合并伤多、伤情重、变化快、休克发生率高;(2)迟发性血气我、膈肌破裂、腰背部伤早期易漏诊;(3)刀刃所致的胸腹联合伤,漏诊或手术处理不当易发生胸腔感染;(4)手术率高,早期救治得当预后好。 相似文献
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目的探讨颈部结核的临床特征、诊断及治疗,以减少其误诊、误治。方法报告53例颈部结核患者的临床资料,结合文献复习,对颈部结核的临床流行病学特点、诊断、治疗等进行分析。结果53例患者经抗结核治疗,其中9例手术治疗,随访6个月-2年无复发。结论耳鼻咽喉科医生必须充分了解颈部结核的临床体征,尽早进行全面检查,减少误诊和漏诊,早期确诊和正规抗结核治疗有利预后。 相似文献
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Impact of radiologic imaging on the surgical decision-making process in suspected appendicitis in children 总被引:1,自引:0,他引:1
RATIONALE AND OBJECTIVES: To evaluate how the surgeons' decision-making process in appendicitis in children is affected by radiologic imaging. MATERIALS AND METHODS: Prospective study including 593 children with suspected appendicitis was conducted. The surgeon's initial clinical disposition was recorded, designating the patient for operation, observation, or discharge. Thereafter, the patients were randomized to undergo either ultrasound only or ultrasound and abdominal computed tomography. The studies were evaluated by radiologists, who indicated if appendicitis was present or not. After radiology was completed, the surgeon re-examined the patient and made the final disposition. The change of disposition pathway was recorded. Final diagnoses were established by means of surgical, histopathologic, and/or clinical follow-up findings. RESULTS: Two hundred forty-four patients had appendicitis. The initial clinical disposition called for 88 operations, 338 observations, and 167 discharges. In total, 347 patients had their treatment plan changed from the initial disposition, resulting in 252 operations, 65 observations, and 276 discharges. In 11 patients, an unnecessary operation was possibly avoided. In 28 patients who turned out to have appendicitis, a possible inappropriate discharge was avoided. Eighteen patients had a false-negative radiologic diagnosis. Of these, 17 underwent surgery because of convincing clinical findings. The difference between the impact on surgeons' decision-making between the two randomized groups was not substantially different. The negative appendectomy rate was 3.7%. CONCLUSION: Radiologic imaging with ultrasound and/or computed tomography provides valuable guidance whether a patient should be discharged, observed, or given surgical treatment, leading to beneficial changes in management plan. Still, false-negative results may occur and a close clinical re-examination is of utmost importance for the appropriate final decision. 相似文献
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A 79 years male with fishbone-induced acute appendicitis was treated surgically with laparoscopic procedure. In preoperative diagnostic study, 3-dimensional multidetector-computed tomography (3D-MDCT) demonstrated the foreign body in the appendix and 3D-reconstructed images seemed fishbone with sharp-pointed dorsal fin directing to the tip of the appendix. With these findings, surgical indication of appendectomy was confirmed and laparoscopic appendectomy was performed. He made a full recovery and was discharged in a satisfactory condition following 7 days of post-operative treatment. From this case experience, 3D-MDCT seems helpful to visualize details of foreign bodies in the appendix, and valuable to confirm surgical indication of complicated acute appendicitis. 相似文献
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目的分析284例异位妊娠误诊的主要原因,降低异位妊娠的误诊率。方法对异位妊娠误诊的284例病历资料进行回顾性分析。结果早期临床症状的不典型;辅助检查的误导;临床医师对病史、体征的采集不全;专业知识欠缺以及临床思维方法不当,是异住妊娠误诊的主要原因。结论客观、仔细、全面的分析判断病情,掌握科学的临床思维方法,才能将异位妊娠的误诊降低到最低水平。 相似文献
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目的探讨会阴部坏死性筋膜炎的发病机制、治疗要点及误诊原因,提高该病的临床诊疗水平。方法对8例误诊的会阴部坏死性筋膜炎患者的临床资料进行回顾性分析,总结其误诊原因,并在明确诊断后采用手术切开引流配合湿润烧伤膏药纱引流治疗,观察、分析该疗法的有效性,并归纳总结该病的诊疗方案。结果 8例患者中有6例因痔疮史被误诊为"肛周脓肿";1例因阴囊处皮肤被蚊虫叮咬后肿痛、体温升高被误诊为"皮肤软组织感染";1例因会阴部皮肤触痛且有硬结被误诊为"巴氏腺囊肿"。8例患者中有7例在切开引流术后经单纯应用湿润烧伤膏药纱引流治疗14~20 d后创面愈合;另外1例经湿润烧伤膏药纱引流治疗至肉芽组织完全覆盖创面后,给予手术植皮封闭创面,术后1个月创面完全愈合。所有患者随访0.5~6年,均未复发。结论临床医生应加强对会阴部坏死性筋膜炎的认识,选择合适的治疗方案,以减少误诊误治。 相似文献