最后审阅: 18 五月 2021
最后更新: 04 一月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 右上腹或者上腹部疼痛(通常持续 >30 分钟
  • 存在的危险因素

其他诊断因素

  • 餐后痛
  • 右上象限或上腹部压痛
  • 恶心
  • 黄疸

危险因素

  • 年龄增长
  • 女性
  • 肥胖、糖尿病和代谢综合征
  • 胆石症家族史
  • 基因突变
  • 妊娠/外源性雌激素
  • 非酒精性肝脏疾病
  • 长时间的饥饿或者体重短期内快速下降
  • 全胃肠外营养 (TPN)
  • 药物治疗
  • 回肠末端疾病或者切除
  • 血红蛋白病
  • 拉丁美洲和美国土著人
  • 低膳食纤维饮食
  • 幽门螺杆菌胆囊感染

诊断性检查

首要检查

  • 腹部超声
  • 血清肝功能检查
  • 全血细胞计数 (FBC
  • 血清脂肪酶或者淀粉酶

需考虑的检查

  • 磁共振胰胆管造影术 (MRCP)
  • 超声内镜扫描(EUS
  • 腹部 CT 扫描

治疗流程

撰稿人

Emeritus Professor of Medicine

Division of Gastroenterology

University of Calgary

Calgary

Canada

利益声明

ES declares that he has no competing interests.

Professor Eldon Shaffer would like to gratefully acknowledge Dr Vikesh K. Singh and Dr Anthony N. Kalloo, previous contributors to this topic.

利益声明

VKS and ANK declare that they have no competing interests.

同行评议者展开全部内容

Consultant General and Hepato-Pancreato-Biliary Surgeon

Clinical Lead for Emergency General Surgery, Gastrointestinal Medicine, and Surgery CSU

Manchester Royal Infirmary

Manchester

Director of Scientific Programme

Association of Surgeons of Great Britain and Ireland

UK

利益声明

CM declares that he has no competing interests.

Consultant in Emergency General Surgery

Service Director for Emergency Assessment Unit (Surgical)

Norfolk and Norwich University Hospitals

Norwich

UK

利益声明

LE declares that he has no competing interests.

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

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