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Confusing diseases: peptic ulcer disease appendicitis anal fistula

Differential diagnosis of colorectal tumors in the elderly

Identification:

1. Appendicitis: cecal cancer often has pain in the right lower abdomen and a mass in the right lower abdomen, and often has fever. It is easy to be misdiagnosed as appendicitis or appendicitis, and the misdiagnosis rate is 25%. It is often diagnosed by combining medical history and barium enema X-ray examination. If it cannot be distinguished, surgical exploration should be used.

2. Digestive tract ulcer, cholecystitis, right colon cancer, especially liver flexure colon, transverse colon cancer, causes discomfort or pain in the upper abdomen, fever, positive fecal occult blood test, right upper abdominal mass, etc. Sometimes misdiagnosed as ulcer disease, cholecystitis, but Combined with medical history and X-ray examination, diagnosis is not difficult.

3. Colon tuberculosis, dysentery, left colon or rectal cancer often have mucus, bloody stools or pus, bloody stools, frequent stools or diarrhea, and are often misdiagnosed as colitis. It is not difficult to differentially diagnose through sigmoidoscopy and careful physical examination.

4. Hemorrhoids: The symptoms of internal hemorrhoids are painless bleeding, which may be blood in the stool, or anal drip or linear bleeding. Patients with rectal cancer also have blood in the stool, but they often have symptoms of anorectal irritation during treatment. The distinction between the two is extremely easy, and the difference can be seen by digital anorectal examination or proctoscopy.

5. Anal fistula: Anal fistula usually first has a paraanal abscess, which starts with local pain. After the abscess is ruptured, it becomes a fistula, the symptoms are relieved, and there is no change in bowel habits and stool properties of rectal cancer or anal cancer.

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