摘要
Abstract
Objective To investigate misdiagnosed causes and preventive measure of diabetic ketoacidosis (DKA) patients with acute abdominal pain as the first manifestation. Methods Clinical data of 32 DKA patients with acute abdominal pain as the first manifestation was retrospectively analyzed, who were admitted during Septemper 2006 and March 2017. Re-sults All patients were acute abdominal pain as the first symptom without diabetes history. There were 12 patients misdiag-nosed as having intestinal obstruction, 10 patients misdiagnosed as having gastroenteritis, 8 patients misdiagnosed as having appendicitis and 2 patients misdiagnosed as having pancreatitis. The misdiagnosed time was 4 h-2 d. Misdiagnosis depart-ments were 30 patients in emergency department, 1 in internal medicine department and 1 in surgery department. All patients received treatments such as fasting, fluid replacement and anti-infection according to misdiagnosed diseases, but symptoms were not relieved obviously. Type 2 diabetes mellitus combined with DKA was confirmed after checking blood glucose, urine glucose and so on. After treatments such as fluid replacement, kalium replacement and insulin venous pump injection, 31 pa-tients were discharged after conditions were improved, and 1 patient died of acute renal failure. Conclusion DKA patients with acute abdominal pain as the first manifestation are easily misdiagnosed, so clinicians should improve understanding of DKA, and give examinations such as blood glucose, urine glucose and urine ketone in time in order to avoid misdiagnosis.关键词
糖尿病酮症酸中毒/腹痛/误诊/肠梗阻/胃肠炎Key words
Diabetic ketoacidosis/Abdominal pain/Misdiagnosis/Intestinal obstruction/Gastroenteritis分类
医药卫生
