Rasmussen O O, Hoffmann J
Department of Surgery D, Glostrup Hospital, University of Copenhagen, Denmark.
J R Coll Surg Edinb. 1991 Dec;36(6):372-7.
The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy.
对急性阑尾炎的体征和症状的可靠性进行了综述。当比较不同研究时，临床发现的广泛差异可能可以通过大量的回顾性研究来解释。疼痛转移至右下腹和/或肌紧张/强直支持阑尾炎的诊断。当不存在厌食、恶心和呕吐，症状持续超过72小时而无明显穿孔，或右下腹无压痛时，应怀疑阑尾炎的诊断。月经前后出现症状、宫颈脱位压痛和双侧附件压痛提示盆腔炎。小儿由于对许多疾病反应一致且相对无法表达自己和配合，穿孔率较高。除老年患者腹胀发生率较高外，青年和老年患者的临床发现相似。通过更全面地了解急性阑尾炎的体征和症状，并始终意识到其可能存在，应该有可能提高诊断准确性。
