最后审阅: 25 五月 2021
最后更新: 02 七月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 便秘/排气或排便停止
  • 危险因素
  • 间歇性腹痛
  • 呕吐
  • 腹胀
  • 腹部压痛
  • 腹部肿块
  • 可触及的直肠肿块
  • 腹膜炎

其他诊断因素

  • 发热
  • 恶心(伴或不伴呕吐
  • 心动过速
  • 腹股沟肿胀

危险因素

  • 既往腹部手术史
  • 肠旋转不良
  • 克罗恩病
  • 阑尾炎
  • 肠道恶性肿瘤
  • 肠套叠
  • 肠扭转
  • 肠扭转
  • 摄入异物

诊断性检查

首要检查

  • 计算机体层成像
  • 水溶性造影剂检查
  • 动脉血气(包括乳酸
  • 全血细胞计数
  • 电解质
  • C 反应蛋白
  • 尿素氮/肌酐比值
  • 血清脂肪酶或者淀粉酶
  • 葡萄糖
  • 凝血、血型鉴定和不规则抗体筛查(group and save),或交叉配血

需考虑的检查

  • 尿液或血清 β–人绒毛膜促性腺激素(human chorionic gonadotrophin, HCG
  • 尿液分析
  • 心电图(ECG
  • 磁共振成像 (magnetic resonance imaging, MRI)

治疗流程

撰稿人

General and Colorectal Surgeon

Queen’s Medical Centre

Nottingham

UK

简介

JA is Clinical Lead for General Surgery, Getting It Right First Time.

利益声明

JA is trustee and council member of the Royal College of Surgeons of England.

Consultant Colorectal Surgeon

Royal Victoria Infirmary

Newcastle-upon-Tyne

UK

利益声明

NR declares she has no competing interests.

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:

John T. Jenkins MD

Consultant Colorectal Surgeon

Department of Coloproctology

St. Mark's Hospital

London

UK

Disclosures: JTJ declares that he has no competing interests.

Edward T. Pring BSc(Hons), MBChB, MRCS

Surgical Registrar and Clinical Research Fellow

St. Mark's Hospital

London

UK

Disclosures: ETP declares that he has no competing interests.

George Malietzis

MBBS, MSc, MRCS

Honorary Clinical Lecturer

Department of Surgery and Cancer

Imperial College London

UK

Disclosures: GM declares that he has no competing interests.

同行评议者展开全部内容

Consultant Colorectal Surgeon

Western Sussex Hospitals NHS Foundation Trust

Chichester

West Sussex

UK

利益声明

Section Editor, BMJ Best Practice

利益声明

EQ declares that she has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Head of Editorial, BMJ Best Practice

利益声明

AE declares that she has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including NICE, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, NCEPOD, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare, and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

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