Klimek Peter, Klimek Miriam, Kessler Ulf, Oesch Valerie, Wolf Rainer, Stranzinger Enno, Mueller Michael D, Zachariou Zacharias
Department of Pediatric Surgery, Inselspital, University of Berne, Berne, Switzerland.
J Med Case Rep. 2012 Dec 12;6:419. doi: 10.1186/1752-1947-6-419.
Most underlying diseases for abdominal pain in children are not dangerous. However some require rapid diagnosis and treatment, such as acute ovarian torsion or appendicitis. Since reaching a diagnosis can be difficult, and delayed treatment of potentially dangerous diseases might have significant consequences, exploratory laparoscopy is a diagnostic and therapeutic option for patients who have unclear and potentially hazardous abdominal diseases. Here we describe a case where the anomaly could not be identified using a laparoscopy in an adolescent girl with acute abdomen.
A 13-year old postmenarchal caucasian female presented with an acute abdomen. Emergency sonography could not exclude ovarian torsion. Accurate diagnosis and treatment were achieved only after an initial laparoscopy followed by a laparotomy and after a magnetic resonance imaging scan a further laparotomy. The underlying disease was hematometra of the right uterine horn in a uterus didelphys in conjunction with an imperforate right cervix.
This report demonstrates that the usual approach for patients with acute abdominal pain may not be sufficient in emergency situations.
儿童腹痛的大多数潜在病因并不危险。然而，有些疾病需要快速诊断和治疗，如急性卵巢扭转或阑尾炎。由于做出诊断可能很困难，而对潜在危险疾病的延迟治疗可能会产生严重后果，对于患有不明且可能危险的腹部疾病的患者，腹腔镜探查术是一种诊断和治疗选择。在此，我们描述了一名患有急腹症的青春期女孩，其异常情况通过腹腔镜检查无法确诊。
一名13岁初潮后的白种女性出现急腹症。急诊超声检查无法排除卵巢扭转。仅在初次腹腔镜检查后进行剖腹手术，以及在磁共振成像扫描后再次进行剖腹手术后，才实现了准确的诊断和治疗。潜在疾病是双子宫右子宫角积血合并右侧宫颈闭锁。
本报告表明，对于急腹症患者，常规方法在紧急情况下可能并不足够。
