Paajanen H, Tainio H, Laato M
Department of Surgery, Kuopio University Hospital, Finland.
Scand J Urol Nephrol. 1996 Oct;30(5):363-6. doi: 10.3109/00365599609181311.
The symptoms of right-sided renal colic mimic sometimes acute appendicitis. A prospective comparative study of 188 patients with ureteral stone and 188 patients with acute appendicitis was performed to evaluate the features of differential diagnosis. Appendicitis caused more often nausea (81 vs 11%), fever and localized pain in the McBurney (97 vs 59%) than renal colic. The patients with ureteral stone had tenderness in 16% in the right lower quadrant. The mean values of C-reactive protein (41 mg/l) and blood leukocytes (14 x 10(9)/l) were elevated in appendicitis, but not in renal colic (14 mg/l and 10 x 10(9)/ l). Urinanalysis revealed red cells in 92% of ureteral stones compared with 26% in appendicitis. Only one of 188 patients with appendicitis was first misdiagnosed to have renal colic. A mistake of appendicitis for ureteral stone is clinically rare occurring only once or twice per year in the hospital where 700-800 emergency appendectomies are annually performed.
右侧肾绞痛的症状有时类似急性阑尾炎。对188例输尿管结石患者和188例急性阑尾炎患者进行了一项前瞻性对照研究，以评估鉴别诊断的特征。与肾绞痛相比，阑尾炎更常引起恶心（81% 对11%）、发热及麦氏点局限性疼痛（97% 对59%）。输尿管结石患者16% 在右下腹有压痛。阑尾炎患者C反应蛋白（41mg/L）和血白细胞（14×10⁹/L）的平均值升高，而肾绞痛患者则未升高（分别为14mg/L和10×10⁹/L）。尿液分析显示，92% 的输尿管结石患者有红细胞，而阑尾炎患者为26%。188例阑尾炎患者中只有1例最初被误诊为肾绞痛。将阑尾炎误诊为输尿管结石在临床上很少见，在每年进行700 - 800例急诊阑尾切除术的医院中，每年仅发生一两次。
