以腹痛及到院前心肺功能停止為主要表現的肺栓塞 —國際機場個案報告及文選回顧

Pulmonary Embolism with Main Manifestations of Abdominal Pain and Out-of-Hospital Cardiac Arrest

「肺栓塞」是少見但致命的疾病，但是由於症狀多變且不具特異性，因而時常被誤診而使病人無法及時獲得妥善治療，進而導致後續的高死亡率。

一位剛下長途飛機的68歲外籍女性，因昏倒及上腹痛向機場醫療中心求助，卻突然發生到院前心肺功能停止，經CPR後回復自發性血液循環，被轉送至北部區域教學醫院急診室，後續被診斷「肺栓塞」。接受緊急治療後，病人病情逐漸改善，並在治療告一段落後，返回越南後續照顧。

腹痛是基層醫療很常見的症狀，而「肺栓塞」也可能以腹痛來表現，是致命的疾病而且容易被延誤診斷。因此家庭醫學科醫師必須對「肺栓塞」的診斷有更高的警覺性，並且列入腹痛的重要鑑別診斷之一。

 

Pulmonary embolism, a rare but fatal disease, is often misdiagnosed due to its varied and non-specific symptoms, thereby preventing patients from receiving timely and appropriate treatment and resulting in a high mortality rate.

A 68-year-old foreign woman, who had just disembarked from a long-distance flight, sought help at the airport medical center due to syncope and upper abdominal pain. However, out-of-hospital cardiac arrest suddenly occurred. With CPR, spontaneous circulation was restored, and she was transferred to a regional teaching hospital, where pulmonary embolism was diagnosed. After emergency treatment, the patient’s condition gradually improved, and she was able to return to Vietnam for follow-up care upon the completion of the treatment.

Abdominal pain is a highly prevalent complaint in primary care; it is also a common manifestation of pulmonary embolism, a fatal disease that can be easily misdiagnosed. Primary care physicians therefore need to maintain a high level of vigilance when diagnosing pulmonary embolism and consider it as one of the important differential diagnoses of abdominal pain.