Abdelhadi M S
Department of Surgery, King Fahd Hospital of the University, College of Medicine, King Faisal University, Dammam, Saudi Arabia.
J Family Community Med. 2001 May;8(2):45-50.
Abdominal pain is perhaps the most challenging of all the presenting complaints in the emergency department. It is estimated that it accounts for 5%-10% of all visits. Causes of abdominal pain range from the inconsequential to the life threatening. In addition, it nearly always poses a greater degree of diagnostic uncertainty in women of child-bearing age as compared to males. Such difficulties become more pronounced in pregnant women where the unwritten policy seems to be: If she is pregnant blame the pregnancy. This policy is justified by the favorable clinical outcomes. However, in a small but significant number of patients, this policy has the potential of creating delays and increasing the risk of unwarranted complications. Delays in management may lead to emotional trauma, loss to the society, and the potential for serious liability.This review was undertaken at King Fahd hospital of the University, Eastern Province of Saudi Arabia, with a literature search covering a period of over twenty years. It mainly highlights the diagnostic difficulties in young women presenting with acute onset abdominal pain, and possible solutions.It also suggests a policy which includes a careful clinical approach with liberal consults between the surgeon and the gynecologist reinforced by a judicious use of the available diagnostic aids leading to potentially favorable outcomes.
腹痛可能是急诊科所有就诊主诉中最具挑战性的。据估计，它占所有就诊病例的5% - 10%。腹痛的原因从无关紧要到危及生命不等。此外，与男性相比，育龄女性的腹痛几乎总是带来更大程度的诊断不确定性。在孕妇中，这种困难更为明显，不成文的政策似乎是：如果她怀孕了，就归咎于怀孕。这种政策因良好的临床结果而合理。然而，在少数但数量可观的患者中，这种政策有可能导致延误并增加不必要并发症的风险。治疗延误可能会导致精神创伤、对社会造成损失以及严重的责任风险。本综述在沙特阿拉伯东部省法赫德国王大学医院进行，文献检索涵盖了二十多年的时间。它主要强调了以急性腹痛就诊的年轻女性的诊断困难以及可能的解决办法。它还提出了一项政策，包括谨慎的临床方法，外科医生和妇科医生之间进行充分会诊，并明智地使用现有的诊断辅助手段，从而可能带来良好的结果。
