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一名26岁的产后腹痛女性。

A 26-Year-Old Woman with Postpartum Abdominal Pain.

作者信息

Burns Luke P, Premkumar Ashish, Czapar Anna, Wu En-Ling, Hutchison Alan L, Jamil Omar, Paul Sonali, Rana Sarosh

机构信息

from the Fellowship Program in Maternal-Fetal Medicine and the Sections of Infectious Diseases and Global Health and Gastroenterology, Hepatology, and Nutrition at the University of Chicago Medical Center.

出版信息

NEJM Evid. 2025 Feb;4(2):EVIDmr2400398. doi: 10.1056/EVIDmr2400398. Epub 2025 Jan 28.

Abstract

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 26-year-old woman who developed acute hepatocellular liver injury following a cesarean delivery for fetal distress. Using targeted questions, physical examination, and diagnostic testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is iteratively refined until a final diagnosis is made.

摘要

摘要晨间病例汇报是一项历史悠久的传统活动,实习医生向同事和临床专家汇报病例,共同探讨有趣的患者病情。晨间病例汇报板块旨在延续这一传统,呈现患者的主要诉求和病例经过,邀请读者与病例作者一同进行鉴别诊断并找出最终诊断结果。本报告探讨了一名26岁女性的病例,该患者因胎儿窘迫行剖宫产术后出现急性肝细胞性肝损伤。通过针对性提问、体格检查和诊断性检测,梳理出该病例的病情概要。随着临床病程的进展,鉴别诊断不断细化,直至得出最终诊断。

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