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周期性呕吐综合征一种可治愈且可能常被忽视的病因。

A curable and probably often-overlooked cause of cyclic vomiting syndrome.

作者信息

Paul Rosman Norman, Dutt Monideep, Nguyen Hiep T

机构信息

Division of Pediatric Neurology, Boston Medical Center, Boston, MA.

Division of Pediatric Neurology, Boston Medical Center, Boston, MA.

出版信息

Semin Pediatr Neurol. 2014 Jun;21(2):60-5. doi: 10.1016/j.spen.2014.04.001. Epub 2014 Apr 3.

Abstract

Cyclic vomiting syndrome is a disorder of many causes. The major challenge is to label the disorder as idiopathic or primary only when all possible etiologies, particularly those that can be specifically treated, have been ruled out. In retrospect, our patient had subtle prenatal and early postnatal radiological findings supportive of a urological cause for his symptoms, the importance of which was initially missed. It would probably be wise to include an abdominal ultrasound examination (looking for hydronephrosis) in the "must-do" battery of tests for the investigation of all cases of recurrent cyclic vomiting without apparent cause. Otherwise, it seems likely that many cases of ureteropelvic junction obstruction will be missed, cases in which surgical intervention can be curative.

摘要

周期性呕吐综合征是一种由多种原因引起的病症。主要挑战在于,只有在排除了所有可能的病因,尤其是那些可以进行特异性治疗的病因之后,才能将该病症标记为特发性或原发性。回顾来看,我们的患者在产前和产后早期有细微的影像学检查结果,支持其症状由泌尿系统病因所致,而这一点最初被忽视了。对于所有无明显病因的复发性周期性呕吐病例的检查,在“必做”的一系列检查中纳入腹部超声检查(以寻找肾积水)可能是明智的。否则,很可能会漏诊许多输尿管肾盂连接部梗阻的病例,而这些病例通过手术干预是可以治愈的。

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