As a common acute abdomen, the clinical signs of
acute pancreatitis are complex and changeable, and the severity of the disease is different, which makes some misunderstandings in the process of diagnosis. The common misunderstandings in the diagnosis of acute pancreatitis will be discussed in detail in order to improve the understanding of the disease, reduce the misdiagnosis rate, and thus improve the prognosis of patients.
1. Misdiagnosis
caused by insufficient understanding of acute pancreatitis
Some patients and their families do not know enough about the severity of acute pancreatitis. When symptoms such as abdominal pain occur, they may be mistaken for other digestive system diseases such as acute gastroenteritis and gastric ulcer, and purchase medication or seek medical treatment in nearby clinics, leading to aggravation of the disease. In addition, if doctors do not know enough about acute pancreatitis, they may misdiagnose it as other diseases, such as biliary tract diseases, intestinal obstruction, appendicitis and so on, thus delaying the opportunity of treatment.
2. Neglecting medical history and clinical signs
.
In the diagnosis of acute pancreatitis, detailed history and careful observation of clinical signs are very important. However, some doctors may ignore the patient’s alcohol consumption, high-fat diet and other incentives, as well as abdominal pain, nausea, vomiting, fever and other typical symptoms, leading to misdiagnosis. In addition, for elderly and pediatric patients, doctors may be more likely to ignore the possibility of acute pancreatitis because of their atypical symptoms and signs.
3. Relying too much on auxiliary examination
Although auxiliary examinations such as blood and urine amylase, lipase, abdominal B ultrasound and CT play an important role in the diagnosis of acute pancreatitis, excessive reliance on these examinations may also lead to misdiagnosis. For example, the elevation of blood and urine amylase may be affected by the time of seeing a doctor, the degree of pancreatic necrosis, hyperlipidemia and other factors. Some patients may have normal or slightly elevated blood and urine amylase in the early stage of acute pancreatitis. At this time, if the possibility of acute pancreatitis is excluded only by this result, it may lead to misdiagnosis. In addition, abdominal B ultrasound or CT examination may also interfere with the diagnosis because of intestinal flatulence and other factors.
4. Be satisfied with the diagnosis
of the original disease
For patients with gallstones, cholecystitis and other diseases in the past, when abdominal pain and other symptoms occur, doctors may be more likely to be satisfied with the diagnosis of the original disease, while ignoring the possibility of acute pancreatitis. This may lead to patients receiving gallbladder surgery and other treatments, the condition is still not alleviated, or even aggravated, and eventually diagnosed as acute pancreatitis.
5. Lack of experience
in special types of pancreatitis There are many special types of
acute pancreatitis, such as early pregnancy with pancreatitis, senile pancreatitis, pediatric pancreatitis and so on. These particular types of pancreatitis are more challenging to diagnose because the patient’s signs and symptoms may be atypical and may be interfered with by other diseases. A physician’s inexperience with these specific types of pancreatitis may lead to misdiagnosis.
6. Measures
to avoid misdiagnosis
In order to avoid misdiagnosis of acute pancreatitis, doctors should strengthen the study and research of the disease and improve their understanding of it. In the process of diagnosis, the medical history should be inquired in detail, the clinical signs should be observed carefully, and the results of auxiliary examinations should be analyzed comprehensively. For patients with suspected acute pancreatitis, blood and urine amylase, lipase, abdominal B-mode ultrasound or CT should be examined in time to make a definite diagnosis. At the same time, doctors should remain vigilant and conduct further examinations and evaluations to exclude the possibility of other diseases in patients with atypical symptoms or complex conditions.
To sum up, the diagnostic errors of acute pancreatitis mainly include insufficient understanding of the disease, neglect of medical history and clinical signs, over-reliance on auxiliary examinations, satisfaction with the diagnosis of the original disease and lack of experience in special types of pancreatitis. In order to reduce the misdiagnosis rate, doctors should strengthen the study and research of the disease, improve the accuracy of diagnosis, and thus improve the prognosis of patients.
Acute pancreatitis
