Hashmi Khawar Sibtain, Ellul Thomas, Leopard Daniel Charles, Woodward Alan
Department of General Surgery, Royal Glamorgan Hospital, Pontyclun, UK.
BMJ Case Rep. 2012 Sep 7;2012:bcr-2012-006512. doi: 10.1136/bcr-2012-006512.
Spontaneous gastric perforation is rare in children. It is usually associated with prematurity, foreign bodies and trauma. Anorexia nervosa (AN) can be an underlying condition although no cases are reported in the literature. We are reporting a rare case of 1-year-old boy with AN who presented with right iliac fossa (RIF) pain mimicking acute appendicitis. Intraoperative findings proved a gastric perforation. Pathophysiology of this condition in AN is poorly understood. Gastric smooth muscle atrophy and ischaemia can be the possible underlying mechanisms. The case discussed here highlights the fact that any abdominal pain in patients with underlying eating disorders (EDs) should raise suspicion of perforation as diagnosis can be far more complicated.
小儿自发性胃穿孔较为罕见。它通常与早产、异物及外伤有关。尽管文献中未报道过相关病例，但神经性厌食症（AN）可能是其潜在病因。我们报告一例罕见的1岁患神经性厌食症男孩，表现为右下腹（RIF）疼痛，酷似急性阑尾炎。术中发现为胃穿孔。神经性厌食症患者出现这种情况的病理生理学机制尚不清楚。胃平滑肌萎缩和缺血可能是潜在机制。本文讨论的病例凸显了这样一个事实，即患有潜在饮食失调（EDs）的患者出现任何腹痛都应怀疑有穿孔可能，因为诊断可能会复杂得多。
