Hoffman S H
Department of Emergency Services, San Francisco General Hospital, California.
Emerg Med Clin North Am. 1989 Aug;7(3):591-609.
In conclusion, the most important task in evaluating an immigrant or traveler with abdominal pain is to consider the myriad tropical diseases that mimic common western conditions. A careful history may point to antecedent symptoms and a time course that are incompatible with typical appendicitis, biliary colic, or bowel obstruction, but physical examination is generally not specific enough to differentiate between tropical and ordinary abdominal crises. Blood work for eosinophilia and a rapid examination of the stools by an experienced technician may indicate a need for judicious delay in exploratory laparotomy. In this interval, imaging studies, serologic tests, and therapeutic drug trials may clarify the diagnosis.
总之，评估有腹痛症状的移民或旅行者时，最重要的任务是考虑到众多模仿常见西方疾病的热带疾病。详细的病史可能会提示一些先前症状以及与典型阑尾炎、胆绞痛或肠梗阻不相符的病程，但体格检查通常不够具有特异性，无法区分热带性和普通的腹部急症。检查血液中的嗜酸性粒细胞，并由经验丰富的技术人员对粪便进行快速检查，可能表明需要明智地推迟 exploratory laparotomy（此处原文有误，推测可能是exploratory laparoscopy，即“腹腔镜探查术”）。在此期间，影像学检查、血清学检测和治疗性药物试验可能会明确诊断。
