急性主动脉夹层9例误诊分析

9 cases misdiagnosis analysis of acute aortic dissection （AAD） with abdominal pain

目的 探讨以腹痛为主要表现的急性主动脉夹层的特点,以减少误诊.方法 对9例以腹痛为主要表现的急性主动脉夹层误诊患者的症状、体征、辅助检查做回顾性分析.结果 本组9例均有不同程度的误诊,误诊时间2～96 h,分别误诊为胆石症、急性胃炎、急性肠炎、肾结石、雷诺病、心绞痛、感染性休克等.结论 以腹痛为主要表现的急性主动脉夹层极易误诊,当腹痛有沿主动脉伸展方向转移,并伴血白细胞明显升高时,应及时进行主动脉的CTA检查.

Objective To explore the causes of misdiagnosis and early diagnostic strategy for acute aortic dissection （AAD） with abdominal pain. Methods The clinical data of 9 cases AAD patients with abdominal pain were analyzed retrospectively. Results 9 cases were diagnosed in first visiting in 2-96 hours. 9 cases were misdiagnosed respectively as gall stones, acute gastritis, acute enteritis, kidney stone, Raynaud disease, angina and infectious shock. Conclusion The AAD with abdominal pain lack specificity clinical manifestation, misdiagnosed easily. When the pain spreads along the long axis of aortic, along with leukocyte increased markedly, a CTA scan should be performed in time.