Misdiagnosed as acute appendicitis in gynecologic

ncycgdxhl · Wysłany: Śro 21:39, 23 Mar 2011

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Gynecologic emergency misdiagnosed as acute appendicitis in 12 Cases

When the blood mainly symptoms of right lower quadrant peritoneal irritation, easily lead to misdiagnosis, but their clinical signs and different appendicitis, diagnosis is the key to pay attention to menstrual history and gynecological examination. Ruptured ectopic pregnancy are often the history of infertility, menopause, irregular menstrual history or recent history. Signs and more signs of anemia or hemorrhage shock. Gynecological examination can be found in blood in the vagina, cervix soft and give pain, and the puncture after the dome is not full of blood coagulation, and palpable mass in the annex. 5 cases of misdiagnosis in this group, there was 1 case of tubal ligation, it will stop misunderstood by history as 1 case readme unmarried,[link widoczny dla zalogowanych], nor the ectopic pregnancy into account, so preoperative testing without making shifting dullness and abdominal paracentesis. Lack of muscular tension in 3 cases but rebound tenderness signs and did not consider the internal bleeding caused by non-inflammatory stimuli. Causes of anemia did not pay attention, this group of ruptured ectopic pregnancy in 5 cases, 4 cases had varying degrees of anemia, and acute appendicitis often do not cause anemia, bleeding time should be thought of gynecological diseases, is also an important basis for excluding appendicitis. Gynecological examination in clinic examination or DRE should not be ignored, abdominal pain, sudden tear was sustained, and sometimes aggravated, nausea, vomiting and a sense of meaning associated with it a sense of who or anus fall, often prompted pelvic fluid, or consultation required within the anal consultation and culdocentesis. Although this check is very important, but easily, as the clinicians are anxious, to have menopause or recent history of irregular vaginal bleeding of women, sudden right lower abdominal pain should be thought of the possibility of ectopic pregnancy. B-ultrasound and human chorionic gonadotropin test will help diagnosis. 2.2 ovarian cyst or tubal cyst torsion ovarian cyst or tubal cyst torsion, abdominal pain and acute appendicitis, although similar, but the sudden and severe than appendicitis,[link widoczny dla zalogowanych], as paroxysmal colic. As blood circulation caused by cyst torsion barrier. Bloody exudate within the abdominal cavity may have, or even cyst necrosis, often with mild shock symptoms. Early abdominal wall soft, often palpable in the Ministry of tumor tenderness, peritoneal irritation late stage, such as twist to natural recovery,[link widoczny dla zalogowanych], the pain may be paroxysmal. 4 patients in this group of misdiagnosis, is a lack of depth and detailed analysis of history. In the past has been to meet the press Appendicitis usually slow onset of abdominal pain, the pain gradually increased, in most cases, the characteristics of metastatic abdominal pain. 3 cases of abdominal pain in this group is sudden,[link widoczny dla zalogowanych], and started right lower abdomen, burst increased, and inflammatory pain apparently there is a difference. In addition, hit in the right lower quadrant abdominal mass should pay attention bimanual vaginal, tactile relationship between the tumor and the uterus, the diagnosis of decisive significance. B-ultrasound is also of great help. 2.3 rupture of ovarian follicular or luteal phase reproductive age, the most common, mostly in medium or menstruation before the onset of menstruation. Sudden severe abdominal pain, persistent falling short into the pain, then gradually reduced. Check point right lower quadrant tenderness and Maxwell rebound tenderness. Lack of typical symptoms of the disease, can easily be confused with acute appendicitis, resulting in misdiagnosis. 2 patients in this group occurred in the mid-term period. Physical examination, but more diffuse right lower quadrant tenderness without muscle tension. Misdiagnosed due to not pay attention to menstrual history, without a gynecological examination. Such as gynecological examinations, can be found to promote the uterus pain got worse, such as the patient after the onset of sexual intercourse, it can rule out acute appendicitis. 2.4 Acute salpingitis is the most common pelvic genital inflammation in a kind of disease occurred in the reproductive age woman, the main clinical manifestations: bilateral lower abdominal pain, and the diffusion from the bottom up, without the transfer of acute appendicitis abdominal pain; with fever, pulse rate, white blood cell count increased significantly; systemic reactions more severe acute appendicitis. Physical examination, abdominal tenderness over parts of appendicitis is low, salpingitis vaginal discharge, or was bloody strong, posterior fornix with touch pain, swelling and sometimes accessories can be touched. The right side of the group 1 patients Misdiagnosis of Salpingitis: ignore the difference between these two diseases, not pay attention to ventilation in patients with recent line of tubal surgery, obstetrics and gynecology consultation is not requested. (Responsibility Proofreading: Pengchao Long) Acutejynecologydeasediagnosedasacuteappendicitis · - theanal3 0l1. PengZhao-ong, '... one hundred and eleven ... a ... a ... a ... a ...' a 'a''one''''''。 ''''''''', T. ÷ 21 century, the seven problems afflicting humankind has {!'÷; of United Nations Environment Programme, 2l century, global environmental trends, said: entrance problems,:; food problem, energy, water resources, and ozone depletion, forest degradation , acid rain increased into difficulties;; seven human interference problems. : * 53 *