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近期,我院附属医院收治2例诊断为急性阑尾炎患者,术后回报1例为胃十二指肠溃疡穿孔,1例为大网膜扭转远端缺血性坏死,现将误诊原因分析如下。1病历摘要例1:男,35岁。上午11:00出现上腹部疼痛,40 min后蔓延至全腹部疼痛伴大汗,感恶心,故急诊入院。既往有胃炎病史3 a。查体:T 37.2℃,P 100次/min,R 18次/min,BP 120/80 mm Hg,神态清楚,急性痛苦病容,被动体位,心肺无异常。腹部平坦,未见胃肠型及蠕动波,上腹部及右下腹有压痛及反跳痛,腹肌轻度紧张,肝脾肋下未触及
Recently, 2 cases of patients with acute appendicitis were diagnosed in the affiliated hospital of our hospital. One case was gastroduodenal ulcer perforation after operation and one case was omental repair of distal ischemic necrosis. The causes of misdiagnosis are as follows. 1 case summary 1: male, 35 years old. The pain in the abdomen occurred at 11:00 in the morning and spread to the whole abdominal pain with sweating and nausea after 40 minutes. Therefore, the emergency department was admitted. Past history of gastritis 3 a. Examination: T 37.2 ℃, P 100 beats / min, R 18 beats / min, BP 120/80 mm Hg, demeanor clear, acute pain, passive position, no abnormal heart and lung. Abdominal flat, no gastrointestinal type and peristaltic waves, upper abdomen and right lower quadrant tenderness and rebound tenderness, mild abdominal muscle tension, liver and spleen ribs did not touch