右半结肠癌延误诊断的原因分析

The Reason of Delay in the Diagnosis of Right Side Colon Cancer

的 :减少右半结肠癌的误诊和漏诊。方法 :分析我院结肠镜检查证实的右半结肠癌患者的病史 ,了解在诊断过程中有无误诊或漏诊发生 ,分析其原因。结果 :共有 32例在结肠镜检查明确诊断前存在漏诊或误诊 ,诊断为急性阑尾炎 9例 ,慢性阑尾炎 5例 ,阑尾周围脓肿 6例 ,贫血、粘连性肠梗阻和慢性结肠炎各 2例 ,十二指肠溃疡和慢性胆囊炎各 1例。钡灌肠和结肠镜检查漏诊各 2例。结论 :仔细询问病史 ,对于右侧腹痛、腹块、便血、贫血等症状的患者要想到右半结肠癌的可能 ,尽早行钡灌肠或肠镜检查 ,检查阴性但临床上仍怀疑时 ,应重复检查避免漏诊。

Objective: It can often be seen that the d iagnosis of right side colon cancer is delayed. How can we avoid it?Methods:The histories of the patients who were diagnosed as righ t side colon cancer by colonoscopy in our hospital were reviewed retrospectively . We find the diagnosis of 32 patients was delayed for many reasons. Results: 9 cases were misdiagnosed as acute appendicitis, 5 case s as chronic appendicitis, 6 cases as appendicular abscess, 2 cases as anemia, 2 cases as intestinal obstruction, 2 cases as chronic colitis, one case as duoden al ulcer and one case as chronic cholecystitis. 2 cases with right side colon ca ncer weren't found in barium enema as well as 2 cases in colonoscopy. Conclusion:Patients with right abdominal pain, mass, hematochezi a and anemia should be considered as right side colon cancer and further diagnos tic examinations, especially barium enema and colonoscopy, are necessary. These examinations should be repeated when the patients are clinically considered as c olon cancer but the examinations are negative.