Boleslawski E, Panis Y, Benoist S, Denet C, Mariani P, Valleur P
Department of Surgery, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
World J Surg. 1999 Mar;23(3):262-4. doi: 10.1007/pl00013181.
The aim of this prospective study was to determine whether plain abdominal radiographs (PAX) are helpful in the management of adult patients presenting with acute pain of the right lower quadrant (RLQ). A questionnaire was filled in for each patient admitted to our hospital for acute abdominal pain of the RLQ, before and after PAX were obtained. The initial questionnaire indicated the suspected diagnosis and a provisional therapeutic option. A total of 104 consecutive patients were included in this study, 76 of whom underwent surgery. The negative laparotomy rate was 22%. PAX changed the suspected diagnosis and management for six patients (6%), leading in one case to negative laparotomy. Of the remaining five patients, three were operated (two for acute appendicitis and one for small bowel obstruction), and two were treated conservatively for ureteral calculi. This prospective study seems to demonstrate that the indiscriminate use of PAX is not helpful for most patients with acute pain of the RLQ. However, it may be performed in selected patients with clinically suspected small bowel obstruction or urinary symptoms.
这项前瞻性研究的目的是确定腹部平片（PAX）对右下象限（RLQ）急性疼痛的成年患者的治疗是否有帮助。在获取PAX前后，为我院因RLQ急性腹痛入院的每位患者填写了一份问卷。初始问卷表明了疑似诊断和临时治疗方案。本研究共纳入104例连续患者，其中76例接受了手术。阴性剖腹率为22%。PAX改变了6例患者（6%）的疑似诊断和治疗方案，其中1例导致阴性剖腹。其余5例患者中，3例接受了手术（2例为急性阑尾炎，1例为小肠梗阻），2例因输尿管结石接受保守治疗。这项前瞻性研究似乎表明，不加选择地使用PAX对大多数RLQ急性疼痛患者没有帮助。然而，对于临床怀疑小肠梗阻或有泌尿系统症状的特定患者，可以进行PAX检查。
