CAJ | 학술논문

目的：分析胰腺疾患误诊为泌尿系结石的常见原因。方法：对本院近10年收治的首诊误诊为泌尿系结石的5例胰腺疾病患者的临床资料进行回顾性分析。结果：4例急性胰腺炎误诊为左上尿路结石，1例胰管结石误诊为右肾结石，均有明显的腰痛，伴有不同程度的上腹痛、恶心、呕吐、腹胀等腹部症状，误诊时间2～4天，3例治愈，2例重症胰腺炎死亡。结论：对临床疑诊为泌尿系结石的腰痛或急性肾功能衰竭患者，如伴有难以解释的腹部症状，尤其是以上腹痛起病者，要考虑到急性胰腺炎等胰腺疾患的可能性；对泌尿系结石患者行ESWL或手术治疗之前应常规进行IVU检查。
목적：분석이선질환오진위비뇨계결석적상견원인。방법：대본원근10년수치적수진오진위비뇨계결석적5례이선질병환자적림상자료진행회고성분석。결과：4례급성이선염오진위좌상뇨로결석，1례이관결석오진위우신결석，균유명현적요통，반유불동정도적상복통、악심、구토、복창등복부증상，오진시간2～4천，3례치유，2례중증이선염사망。결론：대림상의진위비뇨계결석적요통혹급성신공능쇠갈환자，여반유난이해석적복부증상，우기시이상복통기병자，요고필도급성이선염등이선질환적가능성；대비뇨계결석환자행ESWL혹수술치료지전응상규진행IVU검사。
Objective To analyze the causes of misdiagnosis of pancreatic disorders as urinary lithiasis.Methods The clinical data of 5 cases of pancreatic disorders misdiagnosed as urinary lithiasis in our hospital in the recent decade were reviewed.Results 4 cases of acute pancreatitis with left lumbago were misdiagnosed as lithiasis of left upper urinary tract, and a case of pancreatic duct stone was misdiagnosed as right renal stone. All the 5 cases had some abdominal symptoms such as pain in the upper abdomen, nausea, vomiting and abdominal distension. The misdiagnoses lasted 2-4 days when the correct diagnoses were made. 3 cases survived, and 2 cases of severe pancreatitis died eventually.Conclusions For a patient previously diagnosed urinary lithiasis because of lumbago or acute renal failure, the diagnosis of acute pancreatitis should be also suspected if there are inexplainable abdominal symptoms, especially when the pain rises from the upper abdomen. Intravenous urography should be routinely carried out for the patients with urinary lithiasis who is ready to receive extracorporeal shockwave lithotripsy or surgical treatment.