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先天性泌尿生殖系统异常、疾病及妊娠中阑尾炎症状学的模仿

Mimicry of Appendicitis Symptomatology in Congenital Anomalies and Diseases of the Genitourinary System and Pregnancy.

作者信息

Dalpiaz Amanda, Gandhi Jason, Smith Noel L, Dagur Gautam, Schwamb Richard, Weissbart Steven J, Khan Sardar Ali

机构信息

Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, N.Y., USA.

Foley Plaza Medical, New York, N.Y., USA.

出版信息

Curr Urol. 2017 Jan;9(4):169-178. doi: 10.1159/000447136. Epub 2016 Dec 26.

Abstract

INTRODUCTION

Appendicitis is a prevailing cause of acute abdomen, but is often difficult to diagnose due to its wide range of symptoms, anatomical variations, and developmental abnormalities. Urological disorders of the genitourinary tract may be closely related to appendicitis due to the close proximity of the appendix to the genitourinary tract. This review provides a summary of the urological complications and simulations of appendicitis. Both typical and urological symptoms of appendicitis are discussed, as well as recommended diagnostic and treatment methods.

METHODS

Medline searches were conducted via PubMed in order to incorporate data from the recent and early literature.

RESULTS

Urological manifestations of appendicitis affect the adrenal glands, kidney, retroperitoneum, ureter, bladder, prostate, scrotum, and penis. Appendicitis in pregnancy is difficult to diagnose due to variations in appendiceal position and trimester-specific symptoms. Ultrasound, CT, and MRI are used in diagnosis of appendicitis and its complications. Treatment of appendicitis may be done via open appendectomy or laparoscopic appendectomy. In some cases, other surgeries are required to treat urological complications, though surgery may be avoided completely in other cases.

CONCLUSION

Clinical presentation and complications of appendicitis vary among patients, especially when the genitourinary tract is involved. Appendicitis may mimic urological disorders and vice versa. Awareness of differential diagnosis and proper diagnostic techniques is important in preventing delayed diagnosis and possible complications. MRI is recommended for diagnosis of pregnant patients. Ultrasound is preferred in patients exhibiting typical symptoms.

摘要

引言

阑尾炎是急性腹痛的常见病因,但由于其症状范围广泛、解剖变异和发育异常,常常难以诊断。由于阑尾与泌尿生殖道位置相邻,泌尿生殖道的泌尿系统疾病可能与阑尾炎密切相关。本综述总结了阑尾炎的泌尿系统并发症及模拟情况。讨论了阑尾炎的典型症状和泌尿系统症状,以及推荐的诊断和治疗方法。

方法

通过PubMed进行Medline检索,以纳入近期和早期文献的数据。

结果

阑尾炎的泌尿系统表现累及肾上腺、肾脏、腹膜后、输尿管、膀胱、前列腺、阴囊和阴茎。由于阑尾位置的变化和特定孕期的症状,妊娠期阑尾炎难以诊断。超声、CT和MRI用于阑尾炎及其并发症的诊断。阑尾炎的治疗可通过开腹阑尾切除术或腹腔镜阑尾切除术进行。在某些情况下,需要进行其他手术来治疗泌尿系统并发症,不过在其他情况下可完全避免手术。

结论

阑尾炎的临床表现和并发症在患者中各不相同,尤其是涉及泌尿生殖道时。阑尾炎可能类似泌尿系统疾病,反之亦然。认识鉴别诊断和正确的诊断技术对于预防延迟诊断和可能的并发症很重要。对于孕妇,建议使用MRI进行诊断。对于表现出典型症状的患者,首选超声检查。

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