Patil R, Smith C, Brown M D
Department of Internal Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.
Am J Gastroenterol. 1999 Dec;94(12):3614-5. doi: 10.1111/j.1572-0241.1999.01617.x.
We present a case of a 29-yr-old female nurse who presented with an 8-h history of abdominal pain. She had had similar episodes (twice/yr) over the last 5 yr, and the pain had usually resolved spontaneously. Prior investigations including laboratory studies, plain films of the abdomen, an abdominal and pelvic ultrasound, and a CT scan yielded no diagnosis. Her pain was previously considered to be either psychosomatic or a variant of irritable bowel syndrome. On this admission, an evaluation and subsequent enteroclysis revealed a left paraduodenal hernia. The importance of considering paraduodenal hernias in the differential diagnosis of unexplained intermittent abdominal pain is discussed here.
我们报告一例29岁的女性护士,她有8小时的腹痛病史。在过去5年中她有过类似发作(每年两次),疼痛通常会自行缓解。之前的检查包括实验室检查、腹部平片、腹部和盆腔超声以及CT扫描,均未得出诊断结果。她的疼痛之前被认为要么是心身性的,要么是肠易激综合征的一种变体。此次入院时,一项评估及随后的小肠灌肠检查发现了左十二指肠旁疝。本文讨论了在不明原因的间歇性腹痛鉴别诊断中考虑十二指肠旁疝的重要性。