PDF(Pubmed)
Abstract：
In this report, we describe a case involving an 80-year-old female who presented to the emergency department with an acute onset of left upper quadrant abdominal pain. The chief complaint misled us down multiple pathways of considering ischemic bowel disease, peptic ulcer disease, and small bowel obstruction. As a result, this led to costly and invasive diagnostic studies. However, the actual cause eventually became apparent - a cutaneous varicella-zoster virus infection. This case underscores the significance of maintaining a comprehensive list of potential diagnoses, particularly in elderly adults who commonly present atypically and often face difficulty expressing their symptoms. It also underlines the diagnostic challenges associated with identifying shingles without cutaneous findings. Early detection is crucial in preventing unnecessary tests, minimizing costs, and avoiding treatment delays. Furthermore, the case is a powerful example of the importance of vaccination, which has been proven to be 68-97% effective in preventing shingles and postherpetic neuralgia, depending on the individual\'s immune function.
摘要：
在这份报告中,我们描述了一例涉及一名80岁女性的病例，她因急性发作左上腹疼痛而到急诊科就诊。主诉误导了我们考虑缺血性肠病的多种途径，消化性溃疡疾病，和小肠梗阻.因此,这导致了昂贵且侵入性的诊断研究。然而,真正的原因最终变得明显-皮肤水痘-带状疱疹病毒感染。这个案例强调了保持一份完整的潜在诊断清单的重要性，特别是在通常表现为非典型并且经常难以表达症状的老年人中。它还强调了与识别没有皮肤发现的带状疱疹相关的诊断挑战。早期检测对于防止不必要的检测至关重要，降低成本，避免治疗延误。此外，这个案例是疫苗接种重要性的有力例证,已被证明在预防带状疱疹和带状疱疹后神经痛方面有68-97％的有效性，取决于个体的免疫功能。
