4例腹型过敏性紫癜误诊为急腹症患者的临床分析

Clinical Analysis of Four Cases with Abdominal Allergic Purpura Misdiagnosed as Acute Abdomen

过敏性紫癜是临床常见的血管变态反应性疾病,患者可能并发肠套叠、肠梗阻、肠穿孔及出血性小肠炎,紫癜可发生在腹痛之后或者同时发生,难以与外科急腹症鉴别。该文分析了4例腹型过敏性紫癜误诊为急腹症患者的临床资料,诊断为急腹症后行常规治疗,效果不理想;发现误诊后采用糖皮质激素治疗,患者症状缓解。腹型过敏性紫癜的诊断难度较高,易出现误诊情况,疾病早期未出现皮肤紫癜时,临床应根据患者特征性的临床表现、腹部彩超特征及内镜检查等联合诊断,降低误诊率。

Allergic purpura is the clinically common vascular allergic disorder,patients may be complicated by intussusception,intestinal obstruction,intestinal perforation and hemorrhagic enteritis.Purpura may occur after or concurrently with abdominal pain,it is difficult to distinguish from surgical acute abdomen.This article analyzes the clinical data of 4 patients with abdominal allergic purpura who were misdiagnosed as acute abdomen,and after diagnosed as acute abdomen,these patient received conventional treatment,and the effect was not satisfactory.After the misdiagnosis was found,glucocorticoids were given and the patient's symptoms were relieved.It is difficult to diagnose abdominal allergic purpura,and misdiagnosis is easy to occur.When there is no skin purpura in the early stage of the disease,the clinical diagnosis should be made based on the patient's characteristic clinical manifestations,abdominal ultrasound features and endoscopy to reduce the misdiagnosis rate.