Piroutek Mary Jane, Brown Lance, Thorp Andrea W
Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354, USA.
Clin Pediatr (Phila). 2012 Mar;51(3):214-8. doi: 10.1177/0009922811431159. Epub 2011 Dec 12.
To describe the incidence of bilious vomiting in infants with infantile hypertrophic pyloric stenosis that presented to a pediatric emergency department.
A retrospective medical record review included all infants who presented to our level 1 pediatric emergency department from January 1, 2005, through December 31, 2009, who were diagnosed intraoperatively with infantile hypertrophic pyloric stenosis. Emesis was determined to be bilious if the vomit was described as "green," "containing bile," or "bilious."
The authors identified 354 infants with infantile hypertrophic pyloric stenosis. The median age was 4 weeks 6 days (range = 11 days to 13 weeks). Bilious emesis was encountered in 1.4% (5/354; 95% confidence interval = 0.5% to 3.2%). The pyloric thickness measurements on ultrasound were significantly smaller in those with bilious emesis compared with those without bilious emesis (z score = 2.64; P = .014).
Bilious emesis was the presenting symptom in a small proportion of infants with infantile hypertrophic pyloric stenosis.
描述到儿科急诊科就诊的婴儿肥厚性幽门狭窄患儿中胆汁性呕吐的发生率。
回顾性病历审查纳入了2005年1月1日至2009年12月31日期间到我们一级儿科急诊科就诊、术中诊断为婴儿肥厚性幽门狭窄的所有婴儿。如果呕吐物被描述为“绿色”、“含有胆汁”或“胆汁样”，则判定呕吐为胆汁性。
作者识别出354例婴儿肥厚性幽门狭窄患儿。中位年龄为4周6天（范围 = 11天至13周）。胆汁性呕吐的发生率为1.4%（5/354；95%置信区间 = 0.5%至3.2%）。与无胆汁性呕吐的患儿相比，有胆汁性呕吐患儿的超声幽门厚度测量值显著更小（z值 = 2.64；P = 0.014）。
胆汁性呕吐是一小部分婴儿肥厚性幽门狭窄患儿的首发症状。
