Errors in the diagnosis in acute pains in the abdomen
Smolenskiĭ, V.S.; Orlov, V.A.; Vedrova, N.N.; Aleksandrova, E.G.
Klinicheskaia Meditsina 59(10): 103-107
1981
ISSN/ISBN: 0023-2149 PMID: 7311403 Document Number: 181805
Data from pathoanatomic studies of 56 patients who died from diseases with abdominal pain were studied. Diagnostic errors were analyzed and revealed 3 groups of causes for the errors. Errors of the 1st group were caused by incorrect interpretation of anamnestic data and patients' complaints (undetected appendicitis in a patient with myocardial infarction and diabetes mellitus as an example). Errors of the 2nd group were due to blind transfer of laboratory and instrumental data on conclusion of specialists with knowledge of the clinical picture and without critical evaluation of the diagnosis made by the physician referring the patient to the hospital (e.g., undetected pleuropneumonia diagnosed as perforative gastric ulcer). Errors of the 3rd group were caused by insufficient knowledge of the early period of the disease, seeing only the unfolded clinical picture (e.g., undetected ischemic colitis and chronic blood supply insufficiency in the basins of the celiac and upper or lower mesenteric artery mistaken for abdominal cancer or acute dysentery). Three case histories illustrating the misdiagnoses are included. A differential diagnosis in all acute abdominal pains is recommended for early diagnosis of the correct disease.