最后审阅: 7 十一月 2021
最后更新: 18 一月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 间歇性腹痛
  • 腹胀
  • 恶心
  • 呕吐
  • 大便习惯改变
  • 危险因素
  • 硬便
  • 软便
  • 空直肠
  • 近期体重减轻
  • 直肠出血
  • 可触及的直肠肿块
  • 可触及腹部包块
  • 腹部鼓胀
  • 发热
  • 腹部压痛
  • 腹部强直

危险因素

  • 结直肠腺瘤或息肉
  • 当前或既往患恶性肿瘤
  • 炎症性肠病
  • 憩室病
  • 当前或既往患疝
  • 妇科疾病
  • 糖尿病
  • 既往腹部手术史
  • 放疗既往史
  • 肠癌家族史
  • 年龄
  • 男性
  • 肥胖
  • 巨结肠
  • 泻药滥用
  • 饮食
  • 饮酒
  • 吸烟

诊断性检查

首要检查

  • 计算机断层扫描
  • 全血细胞计数
  • 电解质
  • C 反应蛋白
  • 尿素氮/肌酐比值
  • 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
  • 动脉血气(包括乳酸)

需考虑的检查

  • β-人绒毛膜促性腺激素
  • 尿液分析
  • 心电图
  • 水溶性造影剂检查
  • 下消化道内镜或软式乙状结肠镜检查

治疗流程

撰稿人

专家顾问

John Abercrombie, FRCS

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.

鸣谢

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

George Malietzis, MBBS, MSc, MRCS

Colorectal Registrar

Department of Coloproctology

St Mark's Hospital

London

UK

John T. Jenkins, MD

Consultant Colorectal Surgeon

Department of Coloproctology

St. Mark's Hospital

London

UK

同行评议者

Ceri Beaton, BMedsci, BMBS, MSc, FRCS

Consultant Colorectal and General Surgeon

North Devon Healthcare NHS Trust

Devon UK

利益声明

CB declares that she has no competing interests.

编辑

Emma Quigley,

Section Editor, BMJ Best Practice

利益声明

EQ declares that she has no competing interests.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Sue Mayor,

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.

Annabel Sidwell,

Comorbidities Editor, BMJ Best Practice

利益声明

AS declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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