Hon Kam Lun Ellis, Cheng Jean, Chow Chung Mo, Cheung Hon Ming, Cheung Kam Lau, Tam Yuk Him, Leung Alexander K C
Prince of Wales Hospital, Shatin, Hong Kong ; Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Case Rep Pediatr. 2013;2013:523569. doi: 10.1155/2013/523569. Epub 2013 Oct 29.
A bezoar is a mass found trapped in the gastrointestinal system. The condition may be associated with pica, especially in developmentally retarded children. Clinical manifestations are usually nonspecific. Endoscopic diagnosis and removal of the foreign materials is often indicated. Occasionally, severe complications may occur. We report two cases to illustrate the clinical features and complications in these children. In the first case, a reliable history was not obtained in the developmentally delayed girl which precluded prompt diagnosis, but the grossly dilated stomach on plain abdominal radiograph gave clues to an underlying insidious mechanical obstruction of upper gastrointestinal tract. In the second case of a normal child, the unrelenting symptoms and weight loss prompt further investigations which revealed the diagnosis. Literature on pediatric bezoar is reviewed. Oesophagoduodenoscopy is the investigation of choice for diagnostic confirmation, but surgical facilities must be available to deal with acute complications.
胃石是一种被困在胃肠道系统中的团块。这种情况可能与异食癖有关，尤其是在发育迟缓的儿童中。临床表现通常不具有特异性。内镜诊断并清除异物往往是必要的。偶尔，可能会发生严重并发症。我们报告两例病例以说明这些儿童的临床特征和并发症。在第一例中，发育迟缓的女孩未获得可靠病史，这妨碍了及时诊断，但腹部平片上胃明显扩张提示存在潜在的隐匿性上消化道机械性梗阻。在第二例正常儿童中，持续的症状和体重减轻促使进一步检查从而明确了诊断。本文对小儿胃石的文献进行了综述。食管十二指肠镜检查是确诊的首选检查方法，但必须具备手术条件以应对急性并发症。
