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腹腔脓肿

最后审阅: 10 Nov 2024
最后更新: 09 Aug 2022

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 发热或低体温
  • 腹痛
  • 直肠压痛和充盈
完整详情

其他诊断因素

  • 心动过速
  • 排便习惯的改变/肠道功能异常
  • 延发性肠梗阻
  • 厌食/食欲不振
  • 恶心和呕吐
  • 可触及肿块
  • 出现脓毒症体征
  • 术前使用皮质类固醇
完整详情

危险因素

  • 近期手术或外伤、阑尾炎、憩室炎或溃疡穿孔
完整详情

诊断性检查

首要检查

  • 白细胞计数
  • 引流培养
  • 腹部 CT 扫描
完整详情

需考虑的检查

  • 血清 CRP
  • 血清红细胞沉降率 (ESR)
  • 脓液革兰染色
  • 血清葡萄糖
  • 腹部超声
  • 腹部 MRI 扫描
完整详情

新兴检查

  • 超声内镜

治疗流程

急症处理

社区获得性腹腔脓肿:非高危,严重程度为轻度至中度

社区获得性腹腔脓肿:高危或严重程度高

院内感染的腹腔脓肿

撰稿人

作者

Laura Kreiner, MD, FACS

Assistant Professor of Surgery

MetroHealth Medical Center

Case Western Reserve University School of Medicine

Cleveland

OH

利益声明

LK declares that she has no competing interests.

鸣谢

Dr Laura Kreiner would like to gratefully acknowledge Dr Ali F. Mallat, Dr Lena M. Napolitano, and Dr Lillian Kao, previous contributors to this topic.

利益声明

AFM declares that he has no competing interests. LMN has been a member of the speakers' bureau and consultant for Merck, Pfizer, Schering-Plough, Ortho-McNeil, Wyeth, and Astellas Pharma. LK declares that she has no competing interests.

同行评议者

James T. Lee, MD, PhD, FACS, FIDSA, FSHEA

Professor of Surgery (retired)

University of Minnesota

Saint Paul

MN

利益声明

JTL declares that he has no competing interests.

Jeffrey A. Claridge, MD, MS, FACS

Director of Research

Division of Trauma, Burns and Critical Care

Assistant Professor

Department of Surgery

MetroHealth Medical Center

Case Western Reserve University School of Medicine

Cleveland

OH

利益声明

JAC declares that he has no competing interests.

Matthew Falagas, MD, MSc, DSc

Director

Alfa Institute of Biomedical Sciences

Marousi

Athens

Greece

利益声明

MF declares that he has no competing interests.

  • 腹腔脓肿 images
  • 鉴别诊断

    • 包裹性腹内血肿
    • 胰腺假性囊肿
    • 憩室或阑尾蜂窝组织炎
    更多 鉴别诊断
  • 指南

    • 美国放射学会标准:对感染积液所做的影像学处理
    • 从全球角度管理腹腔内感染:2017 年 WSES 腹腔内感染管理指南
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  • 患者教育信息

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    更多 患者教育信息
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