Killedar Madhura Milind, Malani Anand S
Bharati Medical College and Hospital, Sangli, India.
Indian J Surg. 2011 Dec;73(6):444-6. doi: 10.1007/s12262-011-0255-0. Epub 2011 Apr 12.
We report a very rare case of HEREDITARY ANGIOEDEMA, presenting as recurrent acute abdomen. A 22 yr old Maharastrian male, law college student, got admitted for about fifteen times in previous three years for severe, acute onset, upper abdominal pain, vomiting, distention and acute exudative inflammatory ascites .The whole episode used to subside spontaneously within 2-3 days with or without conservative general management .He underwent various investigations from far basic type, to advanced and invasive type with each recurrence but without definitive diagnosis. He also underwent unnecessary appendectomy. The authors did a review of his previous records, but didn't find any definite surgical or medical cause for his acute abdomen. Obviously it was something rare. Authors did search for it in various surgical and medical literature and searched extensively on internet for rare causes of abdominal pain which guided them for further appropriate investigations and diagnose him as a case of HEREDITARY ANGIOEDEMA ,as his clinical features and C1-INH,C3-C4 levels were strongly in favour of it . It goes without saying that the internet has become a standard accessory to conventional literature for cases with diagnostic dilemmas and for treatment options as well.
我们报告了一例非常罕见的遗传性血管性水肿病例,表现为复发性急腹症。一名22岁的马哈拉施特拉邦男性,法律系学生,在过去三年中因严重的急性发作性上腹部疼痛、呕吐、腹胀和急性渗出性炎症性腹水入院约15次。整个发作过程通常在2 - 3天内自行缓解,无论是否进行保守的综合治疗。每次复发时,他都接受了从基础类型到先进和侵入性类型的各种检查,但均未明确诊断。他还接受了不必要的阑尾切除术。作者查阅了他以前的病历,但未发现导致他急腹症的确切手术或医学原因。显然这是一种罕见的情况。作者在各种外科和医学文献中进行了查找,并在互联网上广泛搜索腹痛的罕见原因,这为他们进一步进行适当的检查提供了指导,并将他诊断为遗传性血管性水肿病例,因为他的临床特征以及C1-INH、C3 - C4水平都强烈支持这一诊断。不言而喻,对于诊断难题的病例以及治疗选择而言,互联网已成为传统文献的标准辅助工具。