Hospes Romkje Sietske, Rutgers Steven R
Zorggroep Treant, locatie Scheper Ziekenhuis Emmen, afd. Longziekten, Emmen.
Ned Tijdschr Geneeskd. 2015;159:A9111.
Patients who are referred to an emergency department (ED) often have a working diagnosis. Hospital physicians may be inclined to accept this diagnosis and incorrectly link the findings of investigations to it. This may lead to an incorrect definitive diagnosis and therapy.
We present the case of a 36-year-old female who was referred to the ED with a pneumothorax seen on chest x-ray. Findings from history-taking, physical examination and a second chest x-ray taken on the ED were diagnosed as being consistent with pneumothorax and a chest-drain was inserted. However, further investigation showed that she had Swyer-James-Mcleod syndrome which could have been treated conservatively.
This patient was given a chest drain after the working diagnosis of pneumothorax was made. Due to the definite diagnosis of Swyer-James-Mcleod the indication for chest drainage may have been incorrect. If a diagnosis of pneumothorax is suspected, but diagnostic findings suggest otherwise, further investigations should be performed before a chest drain is inserted.
转诊至急诊科（ED）的患者通常有一个初步诊断。医院医生可能倾向于接受这个诊断，并错误地将检查结果与之关联。这可能导致错误的最终诊断和治疗。
我们报告一例36岁女性，因胸部X线显示气胸被转诊至急诊科。通过病史采集、体格检查以及在急诊科拍摄的第二张胸部X线片，诊断结果与气胸相符，并插入了胸腔引流管。然而，进一步检查显示她患有斯怀尔-詹姆斯-麦克劳德综合征，本可采用保守治疗。
该患者在初步诊断为气胸后接受了胸腔引流。由于明确诊断为斯怀尔-詹姆斯-麦克劳德综合征，胸腔引流的指征可能有误。如果怀疑气胸诊断，但诊断结果另有提示，则应在插入胸腔引流管之前进行进一步检查。
