비뇨생식기계 하복부 통증
분야
hwp2. 각 질환별 복통양상
(1)abdominal pregnancy
(2) leaking of ruptured ovarian cyst
(3) torsion of adnexa
(4)acute salphingo - oophoritis
(5) uterine myoma
(6) endometriosis
(7)ovarian cancer
(8)appendicitis
(9)acute diverticulitis
(10)intestinal obstruction
RLQ
both
LLQ
appendicitis
cecal diverticulitis
meckel's diverticulitis
mesenteric adenitis
비뇨생식기계통
ectopic pregnancy
spontaneous / threatened abortionbladder distention(suprapubic area)
mittelschmerz
uterine leiomyomas(suprapubic area)
endometriosis
ovarian cancer(tumor)
ovarian cyst
ovarian cyst(suprapubic area)
ovarian torsion
tubo- ovarian abscess
salpingitis
renal stone
그 외
diverticulitis
colon cancer
CD
irritable bowel synd.
ruptured abdominal aortic aneurysm
inflammatory bowel dz.
pelvic inflammatory dz
abdominal or psoas abscess
abdominal wall hematoma
cystitis
incarcerated or stragulated hernia
sigmoid diverticulitis
volvulus
2. 각 질환별 복통양상 (참고: 아래질환들은 pelvic pain을 동반함)
(1)abdominal pregnancy
-tenderness and guardening in one or both LQ
-hemoperitoneum이 생김에 따라 generalized abdominal distention과 rebounding tenderness가 prominent해짐
(2) leaking of ruptured ovarian cyst
-torsion , rapidly expending , infected leaking되지 않는 한 ovarian cyst는 대개 급성 통증이 없음
-onset은 sudden함.
-abdominal tenderness (+)
(3) torsion of adnexa
-pain이 severe하며 constant함.
-abdominal tenderness(+), localized rebound tenderness(+)
(4)acute salphingo - oophoritis
-direct and rebounding tenderness (+)
-가장 중요한 sign: cervical motion and bilateral adnexal tenderness
(5) uterine myoma
-abdominal tenderness (+)
-mild rebounding tenderness (+)
-일반적으로 무증상이다가 pedunculated myoma의 torsion, infarction, degeneration, submucosal fiborid의 돌출 등에 의해 acute pain 유발.
(6) endometriosis
-대개 rebounding tenderness(-)
(7)ovarian cancer:
-대개 전이가 일어날 때 까지 무증상: 진단 당시 2/3가 advanced stage
-early stage: 종종 lower abdominal distention, pressure 같은 pain을 호소
:rupture or torsion등에 의한 급성 증상은 흔치않다.
-advanced stage: abdominal distention이 있음.
