成人的急性腹痛:评估和诊断
Ken S Yew1, Mary K George2, Heidi B Allred1
1Gundersen Medical Foundation Family Medicine Residency, La Crosse, Wisconsin.
American family physician
|June 16, 2023
概括
急性腹痛需要及时评估,考虑到常见的原因,如胃肠炎和尾炎. 图像检查,如CT扫描和超声波,对于诊断胆病和尿病等疾病至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 诊断成像 诊断成像 诊断成像
- 胃肠病学 胃肠病学
背景情况:
- 急性腹痛是一种频繁的医疗表现,有多种原因.
- 常见的病因包括胃肠炎,胆病,尿病,分泌炎和尾炎.
- 额外腹部条件和妇科问题也必须考虑.
研究的目的:
- 为了总结急性腹痛的诊断方法.
- 突出临床评估和实验室测试的作用.
- 审查适当使用成像模式的情况.
主要方法:
- 临床评估包括疼痛位置,病史和体检.
- 实验室调查:CBC,CRP,肝胆标记物,电解质,肌素,葡萄糖,尿液分析,脂酶和怀孕测试.
- 成像方式:用对比度进行计算机断层扫描 (CT),超声波扫描 (US) 和磁共振成像 (MRI).
主要成果:
- 临床诊断对于某些情况 (例如,尿病,分炎) 是足够的.
- 图像检查对于诊断诸如胆囊炎,尾炎和中肠缺血等疾病至关重要.
- CT是一般的,左上象限和下腹部疼痛;US是右上象限疼痛.
- 美国的护理中心有助于诊断胆病,尿病和尾炎.
- 在患有女性生殖器官的患者中,需要特别考虑妇科病因.
- 在怀孕患者中,MRI优先于CT,因为美国的研究结果不确切.
结论:
- 结合临床评估,实验室测试和向成像的系统方法对于治疗急性腹痛至关重要.
- 选择成像方式取决于疼痛位置和疑似病因.
- 及时诊断和适当的成像改善了患者的结果.
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