Francis C Y, Duffy J N, Whorwell P J, Martin D F
Department of Medicine, University Hospital of South Manchester, United Kingdom.
Am J Gastroenterol. 1996 Jul;91(7):1348-50.
The current recommendation that irritable bowel syndrome (IBS) should be diagnosed positively using minimum investigation raises the possibility that some disorders, particularly gynecological, may be overlooked. Transabdominal ultrasound is now sufficiently sophisticated to allow assessment of all abdominal viscera for associated pathology, and this study was designed to evaluate its role in the diagnosis of IBS.
An ultrasound scan was performed in 125 patients (100 females, 25 males) for whom a confident diagnosis of IBS had been made.
No serious intra-abdominal pathology was encountered, but 20% of females and 8% of males had an ultrasound abnormality. None of these abnormalities resulted in any additional therapeutic measures. A hepatobiliary abnormality was found in similar proportions of males and females (10 vs 8%). Gallstones were most common (5 vs 4%), but in no individual were they considered to entirely account for the presenting symptoms. Eight percent of the women were found to have a pelvic abnormality, but it was not regarded as serious in any of them.
This study confirms that a positive approach to diagnosing IBS is a safe policy. Furthermore, routine ultrasound scanning in IBS is unnecessary and could be counter-productive by detecting many minor abnormalities, which can pose further therapeutic dilemmas.
目前关于肠易激综合征（IBS）应通过最少检查进行阳性诊断的建议增加了某些疾病，特别是妇科疾病可能被忽视的可能性。经腹超声现在已经足够先进，能够对所有腹部脏器进行相关病变评估，本研究旨在评估其在IBS诊断中的作用。
对125例已确诊为IBS的患者（100例女性，25例男性）进行了超声检查。
未发现严重的腹腔内病变，但20%的女性和8%的男性存在超声异常。这些异常均未导致任何额外的治疗措施。男性和女性中发现肝胆异常的比例相似（分别为10%和8%）。胆结石最为常见（分别为5%和4%），但在任何个体中，胆结石都未被认为完全可以解释其出现的症状。8%的女性被发现存在盆腔异常，但在其中任何一例中，盆腔异常都不被认为严重。
本研究证实，对IBS进行阳性诊断是一种安全的策略。此外，IBS患者常规超声检查没有必要，因为检测到许多轻微异常可能会适得其反，这些异常可能会带来更多治疗难题。
