Kumar S
Department of Surgery, Western General Hospital, Edinburgh.
J R Coll Surg Edinb. 1996 Apr;41(2):93-4.
Young women with right iliac fossa pain are commonly referred to general surgeons as possible acute appendicitis. The differential diagnosis that includes pelvic visceral disease may be very difficult to determine clinically, especially when the history and physical signs are equivocal. We believe that diagnostic accuracy may be improved by eliciting precisely the site of abdominal pain. Right-sided low inguinal pain may be referred from the female pelvic viscera in the same way as testicular pain may be referred to the groin, as these viscera derive their autonomic nerve supply from the T10-L2, mainly T12-L1, spinal segments in both sexes. There are no previous reports of the value of the symptom of right-sided low inguinal pain in differentiating pelvic visceral disease from acute appendicitis in young women. This paper reports a prospective study of the discriminant value of this symptom in such patients.
右下腹疼痛的年轻女性通常会被转诊给普通外科医生，怀疑可能是急性阑尾炎。包括盆腔脏器疾病在内的鉴别诊断在临床上可能很难确定，尤其是当病史和体征不明确时。我们认为，通过精确询问腹痛部位可以提高诊断准确性。右侧腹股沟低位疼痛可能是由女性盆腔脏器引起的牵涉痛，就像睾丸疼痛可牵涉至腹股沟一样，因为这些脏器的自主神经供应在男女两性中均来自T10-L2，主要是T12-L1脊髓节段。此前尚无关于右侧腹股沟低位疼痛症状在鉴别年轻女性盆腔脏器疾病与急性阑尾炎方面价值的报道。本文报告了一项关于该症状在此类患者中鉴别价值的前瞻性研究。
