Legome Eric L, Belton Austin L, Murray Robert E, Rao Pat M, Novelline Robert A
Department of Emergency Medicine, Massachusetts General Hospital and Division of Emergency Medicine, Harvard Medical School, Boston, Massachusetts 02114, USA.
J Emerg Med. 2002 Jan;22(1):9-13. doi: 10.1016/s0736-4679(01)00430-9.
We performed a structured retrospective chart review to describe clinical characteristics of Emergency Department (ED) patients diagnosed by history, physical examination, and abdominal computed tomography (CT) scan with epiploic appendagitis (EA). EA is a disease caused by inflammation of the appendix epiploica, subserosal adipose tissue along the colon. It may mimic surgical causes of acute abdominal pain, but is treated conservatively with pain management. There were 19 patients diagnosed with EA, with follow-up performed on 85%. All had focal, nonmigratory symptoms. Common findings included left lower quadrant pain and guarding, and a normal temperature and white cell count. No patient required operation. This preliminary work characterizes some common clinical features of ED patients diagnosed with EA. As use of emergency CT scan for abdominal pain increases, clinicians will encounter this more often. These features should also prompt the clinician to consider CT scan in patients with similar signs and symptoms. Accurate diagnosis may avoid unnecessary surgery.
我们进行了一项结构化回顾性病历审查,以描述通过病史、体格检查和腹部计算机断层扫描(CT)诊断为网膜性阑尾炎(EA)的急诊科(ED)患者的临床特征。EA是一种由结肠旁阑尾(阑尾系膜)的浆膜下脂肪组织炎症引起的疾病。它可能类似急性腹痛的外科病因,但通过疼痛管理进行保守治疗。有19例患者被诊断为EA,85%的患者进行了随访。所有患者均有局限性、非转移性症状。常见表现包括左下腹疼痛和压痛,体温和白细胞计数正常。无一例患者需要手术。这项初步工作描述了诊断为EA的ED患者的一些常见临床特征。随着用于腹痛的急诊CT扫描的使用增加,临床医生将更频繁地遇到这种情况。这些特征也应促使临床医生在有类似体征和症状的患者中考虑进行CT扫描。准确的诊断可以避免不必要的手术。