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我科从1996年1月至1997年9月发生结肠癌被误诊为胆囊结石的患者共15例,现就误诊的原因分析如下.1 临床资料1.1 一般资料 本组15例中,男5例,女10例;年龄47—76岁,平均61岁.从解剖部位看,以横结肠癌(包括肝、脾曲结肠癌)的误诊率最高,其次是升结肠癌.1.2 误诊时间 误诊时间最长者8个月,最短者4天,平均2个月.其中于门诊就诊时误诊者8例,占53.3%;住院检查时误诊者3例,占20.0%;手术时误诊者4例,占26.7%.1.3 主要临床表现 主要为腹痛者14例,占93.3%;发热9例,占60.0%;腹部包块2例,占13.3%;便血7例,占46.7%;贫血6例,占40.0%.无以肠梗阻表现而误诊者.1.4 检查与结果 经X线钡剂灌肠者11例,确认为结肠癌9例(81.8%),疑诊2例;纤维结肠镜检查者12例,确诊为结肠癌12例(100%);手术时探查者3例,确诊为结肠癌2例(66.7%),1例因肿块微
In our department from January 1996 to September 1997, there were 15 patients with colon cancer misdiagnosed as gallstones. The reasons for misdiagnosis are as follows.1 Clinical data 1.1 General information In this group of 15 patients, 5 were male. Female 10 cases; age 47-76 years old, average 61 years old. From the anatomical site, with the highest rate of misdiagnosis of horizontal colon cancer (including liver, spleen and colon cancer), followed by rising colon cancer. 1.2 The longest misdiagnosis time of misdiagnosis 8 months, the shortest 4 days, an average of 2 months. Among them, 8 cases were misdiagnosed at the outpatient consultation, accounting for 53.3%; 3 cases were misdiagnosed during hospitalization examination, accounting for 20.0%; 4 cases were misdiagnosed during the operation, accounting for 26.7% .1.3 The main clinical manifestations were mainly abdominal pain in 14 cases, accounting for 93.3%; fever in 9 cases, accounting for 60.0%; abdominal mass in 2 cases, accounting for 13.3%; hematochezia in 7 cases, accounting for 46.7%; anemia in 6 cases, accounting for 40.0%. There was no indication of intestinal obstruction and misdiagnosis. 1.4 Examinations and results 11 cases were treated with X-ray barium enema, 9 cases (81.8%) were confirmed as colon cancer, 2 cases were suspected, and 12 cases were diagnosed as colon by colonoscopy. 12 cases (100%) of cancer; 3 cases of exploration during surgery, 2 cases of colon cancer diagnosed (66.7%), and 1 case of microscopic tumor