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| Ultrasonographic Findings and causes of Misdiagnosis for Patients with Acute Abdomen Diseases |
| WANG Li, WANG Xu |
| Xiangyang Central Hospital, Hubei Xiangyang 441021, China |
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Abstract Objective: To analyze the ultrasonic findings of acute abdominal diseases and the causes of misdiagnosis. Methods: 100 cases of patients with acute abdominal diseases treated in our hospital from April 2012 to May 2017 were selected and examined with color Doppler ultrasonography. According to the features of ultrasonic images, the types of acute abdominal diseases were diagnosed, and the results were compared with the diagnosis results of operation and pathology. The accuracy and misdiagnosis rate of ultrasonic diagnosis of acute abdominal diseases, and the causes of misdiagnosis were analyzed. Results: According to the sites, size, echo and blood flow images of lesions displayed by ultrasound, it was found that the ultrasonic findings of patients with acute abdominal diseases caused by different causes were obvious. The postoperative pathological diagnosis of 100 patients with acute abdominal diseases showed 19 cases of urinary calculi, 18 cases of hepatic stones and gallstones, 15 cases of acute appendicitis, 11 cases of acute cholecystitis, 10 cases of acute pancreatitis, 10 cases of intestinal obstruction, 12 cases of intestinal perforation, 5 cases of ectopic pregnancy and ovarian torsion, and 1 case of abdominal large vascular disease. The accuracy rate of ultrasonic diagnosis was 84.00%, and the misdiagnosis rate was 16.00%. Among the misdiagnosed patients, there were 2 cases of urinary calculi misdiagnosed as chronic colitis and intestinal obstruction, 1 case of gallstone misdiagnosed as intestinal polyps, 1 case of acute appendicitis misdiagnosed as urinary calculi, 2 cases of acute cholecystitis misdiagnosed as gallstones and cholestasis, 1 case of acute pancreatitis misdiagnosed as intestinal fistula, 1 case of intestinal obstruction and 1 case of intestinal perforation misdiagnosed as acute appendicitis, 2 cases of ectopic pregnancy misdiagnosed as purulent appendicitis and early pregnancy, 3 cases of ovarian torsion misdiagnosed as purulent appendicitis, appendix perforation and early pregnancy, and 1 case of abdominal large vascular disease misdiagnosed as ectopic pregnancy. The causes of misdiagnosis mainly includes poor ultrasonic findings, non obvious signs, atypical ultrasonic features or similar diseases. Conclusion: The accuracy rate of Doppler ultrasound is high in the diagnosis of acute abdominal diseases. However, poor ultrasonic findings, non obvious signs and atypical ultrasonic features may cause misdiagnosis. Other ways can be used for differential diagnosis.
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[1] 龙飞华,赵佩安,彭卓,等.急性腹痛76例病因及误诊原因分析[J].临床误诊误治,2016,29(1):27~29.
[2] 曾德善.基层医院小儿外科急腹症43例临床误诊原因分析及对策[J].湖南中医药大学学报,2016,36(1):198~199.
[3] 张镟,李建宏,段守兴,等.肠系膜淋巴管瘤致小儿急腹症的诊治分析[J].中华小儿外科杂志,2016,37(6):444~448.
[4] 徐飞,陆永萍,汤跃跃.彩色多普勒超声在妇产科急腹症中的临床价值[J].检验医学,2016,14(9):124~125.
[5] 卢江丽.探讨彩色多普勒超声在小儿急腹症中的应用价值[J].世界中医药,2016,11(6):2073~2073.
[6] 戚凌.超声联合CT对成人急腹症的诊断效果[J].检验医学与临床,2017,14(2):254~255.
[7] 宋琦炜.非外伤性急腹症患者超声及CT检查诊断与误漏诊分析[J].临床误诊误治,2016,29(11):49~52.
[8] 沈炳余,徐良志.急腹症超声图像特点及漏误诊分析[J].海军医学杂志,2011,32(2):90~91.
[9] 杨虎,段永珠.以急腹症为表现的其他疾病误诊为急性阑尾炎原因分析[J].临床误诊误治,2015,28(11):15~17.
[10] 吴丽琴.超声诊断妇科急腹症的临床应用及误诊原因分析[J].中国计划生育和妇产科,2016,8(10):44~47.
[11] 刘翠霞.妇科急腹症的超声诊断及误诊原因分析[J].中国医疗设备,2014,29(10):150~152.
[12] 高振利,徐永运.多层螺旋CT与超声检查诊断急诊老年血管源性急腹症患者的临床价值对比[J].中国CT和MRI杂志,2016,14(9):107~109. |
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2018, Vol. 24 
