腹腔穿刺在小兒科腹部急症臨床診斷之應用

The Use of Abdominal Tap as an Aid to the Diagnosis of Acute Abdomen in Pediatric Practice

林昭安(Chao-An Lin) ； 蔡炳照(Peeng-Jou Tsai) ； 林逸良(Yee-Liang Lin) ； 江正德(Chen-Te Chiang)

《Acta Paediatrica Sinica》 13卷4期 (1972/12) Pp. 168-173

摘要

面對小孩之腹部急症，當常規性檢查後，診斷尚難以確立時，對於一個小兒科大夫來講，是一個極大的問題。極須尋求一種迅速、簡單而正確的診斷方法。我們認爲腹腔穿刺術具有此決定性的價值。如此可以避免其他無謂的檢查或能早期決定外科開刀的需要性。我們例舉十個兩三年來在我們醫院小兒科遇到的病例。年齡由新生兒到孩童時期，有各種不同的腹部症狀之病例；包括卵巢瘤、脾臓及內臓破裂引起之內出血或種種原因引起之腹膜炎，經利用腹腔穿刺能早期發現病症之特徵，從而獲得早期治療。我們也要特別的強調，「穿刺沒有得到結果」（陰性穿刺）並不能一槪否定腹腔內沒有病變。同時，對於穿刺術及其安全性、禁忌、穿刺結果解釋，我們也詳加以討論。

並列摘要

A child with an acute abdominal condition is a great challenge to pediatrician. When the diagnosis is in doubt it is mandatory to seek a rapid diagnostic procedure. We feel that abdominal tapping is of decisive value in this role, because it may spare a child additional more hazardous procedures or indicate immediate need for surgical intervention.
Ten cases are presented from neonatal, infant and childhood age groups with varying abdominal conditions which were encountered in this hospital. These cases demonstrate how correct and early diagnoses were obtained with simple abdominal tapping.
The procedure is strongly recommended as a routine in conditions such as generalized peritonitis, intraperitoneal hemorrhage, viseeral perforatien and in all cases of obscure and undiagnosed etiology.
We wish to emphasize that a ”negative tap” should not be concluded as a negative intra-abdominal pathology. Technic of tapping, its safety, contraindication and interpretation of positive results are also discussed.