Hussain Abdulzahra, Mahmood Hind, Singhal Tarun, El-Hasani Shamsi
General Surgery Department, Princess Royal University Hospital, Kent, UK.
J Med Case Rep. 2008 Jun 11;2:199. doi: 10.1186/1752-1947-2-199.
The differential diagnoses of acute abdomen in children include common and rare pathologies. Within this list, different types of bezoars causing gastrointestinal obstruction have been reported in the literature and different methods of management have been described. The aim of this article is to highlight a rare presentation of lactobezoars following prolonged percutaneous endoscopic gastrostomy feeding and its successful surgical management.
A 16-year-old boy was admitted to a paediatric ward with abdominal distension and high output from his permanent gastrostomy feeding tube, with drainage of bilious fluids. The clinical, radiological and endoscopical examinations were suggestive of partial duodenal obstruction with multiple bezoars in the stomach and duodenum. Gastrojejunostomy was performed after the removal of 14 bezoars. The child had an uneventful postoperative course and was discharged on the sixth postoperative day in a stable condition.
Lactobezoars should be included in the differential diagnosis of acute abdominal pain in patients with percutaneous endogastric feeding. Endoscopy is important in making the diagnosis of this surgical condition of the upper gastrointestinal tract in a child.
儿童急腹症的鉴别诊断包括常见和罕见的病症。在这份清单中，文献报道了不同类型的胃石导致胃肠道梗阻，并描述了不同的处理方法。本文的目的是强调长期经皮内镜下胃造口喂养后罕见的乳凝块胃石表现及其成功的手术治疗。
一名16岁男孩因腹胀和永久性胃造口喂养管大量引流胆汁性液体而入住儿科病房。临床、放射学和内镜检查提示十二指肠部分梗阻，胃和十二指肠内有多个胃石。在取出14个胃石后进行了胃空肠吻合术。患儿术后恢复顺利，术后第六天病情稳定出院。
经皮胃内喂养患者急性腹痛的鉴别诊断应包括乳凝块胃石。内镜检查对于诊断儿童上消化道的这种外科病症很重要。
