Fingerhut A, Yahchouchy-Chouillard E, Etienne J C, Ghiles E
Service de chirurgie viscérale et générale Centre hospitalier intercommunal 78 300 Poissy-St-Germain.
Rev Prat. 2001 Oct 1;51(15):1654-6.
Nearly 300,000 appendectomies are performed yearly in France. The negative laparotomy rate for suspected acute appendicitis is about 20%. Appendiceal perforation increases the risk of postoperative complications and may lead to death. Differential diagnosis of right lower quadrant abdominal pain is a major public health problem. Reported means of increasing diagnostic accuracy have included in-hospital observation with clinical and biological structured data collection with or without computer-assisted diagnosis, ultrasonography, CT, and laparoscopy. The ideal diagnostic test is yet to be defined. However, structured clinical examination is the cornerstone of any management algorithm. "When in doubt, take it out" is no longer acceptable.
在法国,每年进行近30万例阑尾切除术。疑似急性阑尾炎的阴性剖腹手术率约为20%。阑尾穿孔会增加术后并发症的风险,并可能导致死亡。右下象限腹痛的鉴别诊断是一个重大的公共卫生问题。据报道,提高诊断准确性的方法包括住院观察,并进行临床和生物学结构化数据收集,可使用或不使用计算机辅助诊断、超声检查、CT和腹腔镜检查。理想的诊断测试尚未确定。然而,结构化临床检查是任何管理算法的基石。“拿不准就切除”的做法已不再被接受。