Mills R W, Burke S
Department of Pediatrics, Medical College of Ohio, Toledo.
Clin Pediatr (Phila). 1990 Aug;29(8):474-7. doi: 10.1177/000992289002900812.
Munchausen's syndrome by Proxy is a well-described entity that may not always be immediately considered in a complicated case. We describe this syndrome being portrayed through the guise of gastrointestinal bleeding in a 15 month old male and discuss not only the difficulty involved in solidifying this diagnosis but also the consequences that may occur should this diagnosis not be entertained. Failure to diagnose Munchausen's syndrome by proxy often results from failure to consider the diagnosis. These cases frequently have specific characteristics that allow seasoned clinicians to suspect the diagnosis. Once the diagnosis is considered, it is crucial to take steps to protect not only the index patient but also siblings who not infrequently are also recipients of this life threatening form of child abuse.
代理型孟乔森综合征是一种已被充分描述的病症，但在复杂病例中可能并非总能立即被想到。我们描述了一名15个月大男性通过伪装成胃肠道出血来呈现这种综合征的情况，并不仅讨论了确诊这种病症的困难，还探讨了如果不考虑这一诊断可能产生的后果。未能诊断出代理型孟乔森综合征往往是因为没有考虑到这一诊断。这些病例通常具有特定特征，使经验丰富的临床医生能够怀疑这一诊断。一旦考虑到这一诊断，采取措施不仅保护索引患者，而且保护兄弟姐妹至关重要，因为他们也常常是这种危及生命的虐待儿童形式的受害者。
