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一名患有雷特综合征女孩的胃穿孔治疗:病例报告

The management of gastric perforation in a girl with Rett syndrome: report of a case.

作者信息

Sezer Atakan, Yagcı Mehmet Ali, Hatipoglu Ahmet Rahmi

机构信息

Department of Surgery, Faculty of Medicine, Trakya University, Edirne 22030, Turkey.

出版信息

Brain Dev. 2011 Jan;33(1):83-5. doi: 10.1016/j.braindev.2010.01.005. Epub 2010 Feb 9.

Abstract

INTRODUCTION

Rett syndrome is a neurologically disorder that affects approximately one in 10,000 females.

CASE REPORT

A 21-year-old girl with Rett syndrome was hospitalized for abdominal distention and pain. Physical examination revealed abdominal tenderness. Radiology investigation revealed bilateral free air in subdiaphragmatic area. Gastric perforation observed at laparotomy. Primary suturing and omentoplasty were performed. In the follow-up, the symptoms of intestinal obstruction occurred. Conservative treatment failed and second intervention was performed. At laparotomy severe gastric and intestinal dilatation and bowel adhesions were detected. Adhesiolysis, tube gastrostomy, and feeding jejunostomy performed.

DISCUSSION

Rett syndrome and associated gastric complications are uncommon. These pathologic disorders may cause gastric, intestinal necrosis, intestinal obstructions. Because of the late occurring of physical findings and insidious presentation of the gastrointestinal perforations in Rett syndrome, physicians should keep in mind this rare entity to reduce morbidity and mortality.

摘要

引言

雷特综合征是一种神经疾病,每10000名女性中约有1人受其影响。

病例报告

一名21岁的雷特综合征女孩因腹胀和腹痛入院。体格检查发现腹部压痛。影像学检查显示双侧膈下区域有游离气体。剖腹手术时发现胃穿孔。进行了一期缝合和网膜成形术。在随访中,出现了肠梗阻症状。保守治疗失败后进行了二次干预。剖腹手术时发现严重的胃肠扩张和肠粘连。进行了粘连松解术、胃造瘘术和空肠造口术。

讨论

雷特综合征及相关胃部并发症并不常见。这些病理疾病可能导致胃、肠坏死及肠梗阻。由于雷特综合征中体格检查结果出现较晚且胃肠道穿孔表现隐匿,医生应牢记这一罕见疾病,以降低发病率和死亡率。

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