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[腹痛——慢性症状患者的鉴别诊断与诊断策略]

[Abdominal pain - differential diagnoses and diagnostic strategies in patients with chronic symptoms].

作者信息

Güller Ulrich, Macpherson Andrew J

机构信息

Universitätsklinik für Viszerale Chirurgie und Medizin, Inselspital, Bern.

出版信息

Ther Umsch. 2011 Aug;68(8):459-62. doi: 10.1024/0040-5930/a000194.

Abstract

Abdominal pain is a very common complaint in a primary care consultation. The causes of abdominal pain are extremely diverse and range from conditions that require urgent surgical remedy to those without serious underlying pathology where the problem either settles spontaneously, or becomes chronic without any abnormalities on laboratory or clinical workup. While tests are helpful in confirming diagnoses, clinical judgement based on a careful history and physical examination remains extremely important in choosing from the extremely wide differential diagnoses and in the management of the condition. In this article, we will deal with chronically recurrent intermittent abdominal pain. Our aim is especially to provide guidance on the possibility that abdominal pain is a symptom of chronic inflammatory bowel disease (IBD) or an identifiable functional condition and when the diagnosis of irritable bowel syndrome should be made.

摘要

腹痛是基层医疗会诊中非常常见的主诉。腹痛的病因极为多样,从需要紧急手术治疗的情况到没有严重潜在病理问题的情况,后者要么会自行缓解,要么会发展为慢性疾病,而实验室检查或临床检查均无异常。虽然检查有助于确诊,但基于详细病史和体格检查的临床判断,在从极为广泛的鉴别诊断中进行选择以及病情管理方面仍然极为重要。在本文中,我们将探讨慢性复发性间歇性腹痛。我们的目标尤其在于就腹痛可能是慢性炎症性肠病(IBD)的症状或可识别的功能性疾病这一情况提供指导,以及何时应做出肠易激综合征的诊断。

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