Hoffmann J, Kurgan A, Abramowitz H B
Isr J Med Sci. 1983 Jun;19(6):505-7.
The accurate diagnosis of acute lower abdominal pain continues to be a problem. In Israel, a diagnostic sign often sought as indicating pelvic peritonitis is a rectal temperature of greater than 1.0 C higher than the simultaneous oral temperature. We established that in each of the 20 emergency rooms surveyed both oral and rectal temperatures are measured as part of the admission procedure for patients with acute lower abdominal pain. The charts of three groups of 100 patients with acute lower abdominal pain were studied retrospectively. A rectal temperature of greater than 1.0 C higher than the oral was found in about 10% of each group. Both oral and rectal temperatures were raised in 56, 69 and 37% of each group, respectively. The rectal temperature alone was elevated in 8.5% of patients with appendicitis or pelvic inflammatory disease (PID), as well as in 6% of patients with undiagnosed abdominal pain. Oral temperatures alone were elevated in 4.5% of patients with acute appendicitis or PID and also in 13% of patients with undiagnosed abdominal pain. These differences were not significant. We conclude that the common Israeli practice of measuring both rectal and oral temperatures in patients with acute lower abdominal pain gives no more information than the measurement of either one.
急性下腹痛的准确诊断仍然是一个难题。在以色列，一个常被视为提示盆腔腹膜炎的诊断体征是直肠温度比同时测量的口腔温度高1.0℃以上。我们发现，在所调查的20个急诊室中，对于急性下腹痛患者，在入院程序中均会测量口腔温度和直肠温度。对三组各100例急性下腹痛患者的病历进行了回顾性研究。每组中约10%的患者直肠温度比口腔温度高1.0℃以上。每组分别有56%、69%和37%的患者口腔温度和直肠温度均升高。仅直肠温度升高的情况在阑尾炎或盆腔炎（PID）患者中占8.5%，在未确诊腹痛的患者中占6%。仅口腔温度升高的情况在急性阑尾炎或PID患者中占4.5%，在未确诊腹痛的患者中占13%。这些差异不显著。我们得出结论，以色列对急性下腹痛患者同时测量直肠温度和口腔温度的常见做法，所提供的信息并不比单独测量其中一项更多。
