Fatima Hospital and Baqai Medical University, Super Highway, Gadap Road, Karachi, Pakistan.
Asian J Surg. 2010 Jul;33(3):107-13. doi: 10.1016/S1015-9584(10)60019-X.
This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever.
This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded.
Among 357 patients with dengue fever, 43 (12.04%) had acute abdomen. There were 15 men and 28 women, with a median age of 29 years. These included 26 cases of acute cholecystitis, 7 cases of acute appendicitis, 7 cases of nonspecific peritonitis, and 3 cases of acute pancreatitis. Dengue hemorrhagic fever/shock syndrome was found in acute pancreatitis, and two of these patients died. Emergency surgery was required in eight patients (5 appendectomy and 3 open cholecystectomy). Substantial transfusion of blood and its components was required in eight patients who underwent emergency surgery.
Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity.
本研究旨在确定登革热患者中急性腹痛的频率、模式和处理方法。
本描述性病例系列研究是对巴基斯坦卡拉奇的三家二级护理医院 2005 年 6 月 1 日至 2008 年 12 月 31 日期间登革热患者急性腹痛的前瞻性分析。纳入标准为所有确诊为登革热的患者。排除了实验室、超声或组织病理学数据不完整的患者。
在 357 例登革热患者中，有 43 例（12.04%）出现急性腹痛。其中男性 15 例，女性 28 例，中位年龄 29 岁。包括急性胆囊炎 26 例，急性阑尾炎 7 例，非特异性腹膜炎 7 例，急性胰腺炎 3 例。在急性胰腺炎中发现登革出血热/休克综合征，其中 2 例患者死亡。8 例患者需要紧急手术（5 例阑尾切除术和 3 例胆囊切除术）。接受紧急手术的 8 例患者需要大量输血及其成分。
需要早期诊断和及时保守治疗登革热急性腹痛，以避免死亡率和与急诊手术相关的发病率。但是，如果需要，手术可以在可接受的发病率下进行。
