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文件名称:急性腹痛英文课件.ppt
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更新时间:2025-06-26
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AcuteAbdomenStuartDanovitch,MDWashingtonVAMedicalCenter11/981急性腹痛英文

AcuteAbdomen-ConundrumIfIoperateandtheproblemisnotsurgical,patientexposedtounnecessaryrisk,anesthetic,etc.Risksgreaterwithconcomitantillness,olderageIfIdonotoperateandproblemissurgical,patientatriskbecauseofwrongtherapy.Againtheolderpatientisundergreaterburden.11/982急性腹痛英文

ACaricature-SurgeryAcutepainSeptictoxicBoard-likeabdomenAbsentbowelsoundsWBC25,000Freeairunderdiaphragm11/983急性腹痛英文

ACaricature-NoSurgeryTrivialpainRobustappearanceSoftabdomenwithnoguardingNormalbowelsoundsNormalWBCNormalpainanduprightfilmsofabdomen11/984急性腹痛英文

AcuteAbdominalPain

Non-surgicalEmergenciesMesentericAdenitisAcuteEntericInfectionsAcuteEntericPoisoningsInflammatoryBowelDiseasePancreatitis(usually)11/985急性腹痛英文

AcuteAbdominalPain

MetabolicCausesDiabeticKetoacidosisHeavyMetalPoisoningAcutePorphyriaTabesSickleCellCrisis11/986急性腹痛英文

AcuteAbdominalPain

ClinicalPhenomena2/3ofattackstypical,1/3atypicalAcutecholecystitisandperforatedDUarerare,20yearsAcutediverticulitisrate,30years80%ofpatientswithbowelobstructionhadprevioussurgery75%ofpatientswithcholecystitishadpreviousattacks11/987急性腹痛英文

AcuteAbdominalPain

ConfoundingClinicalFeaturesPerforatedduodenalulcer50%ofpatientshadnopreviouspain50%ofpatientshadbowelsoundsDiverticulitis40%ofpatientsvomited30%ofpatientshaveupperpainObstruction40%ofpatientshavenodistension11/988急性腹痛英文

AcuteAbdominalPain

AncillaryDiagnosticStudiesCBCUrineAmylasePlainabdominalfilmsParacentesisandlavageRadionuclideScans11/989急性腹痛英文

AcuteAbdominalPain

TheWBCin570patientsDiagnosis Sensitivity% Specificity%Appendicitis(?) 91 21Cholecystitis(?) 78 11Obstruction(?) 56 8Gastroenteritis(N) 49 11OtherNon-surgical(N) 62 82Predictivevalueof?WBCforsurgicalcondition 29%Predictivevalueof?WBCf