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一名15个月大的男孩,因食物嵌塞导致先天性十二指肠狭窄。

A 15-month-old boy with congenital duodenal stenosis due to food impaction.

作者信息

Nakajima Junya, Takahashi Hidekuni, Suda Kazuto, Suzuki Shunske, Sato Satoshi, Hayashi Yutaka, Kawashima Hisashi

机构信息

From the *Department of Pediatrics, Tokyo Medical University; and †Third Department of Surgery, Tokyo Medical University, Tokyo, Japan.

出版信息

Pediatr Emerg Care. 2015 Feb;31(2):132-4. doi: 10.1097/PEC.0000000000000354.

Abstract

Duodenal stenosis is a type of congenital intestinal atresia syndrome. Most patients are diagnosed during the neonatal period based on recurrent vomiting, but some cases develop symptoms at an older age. We report a case with an unusual pathogenic mechanism: sudden ileus due to food impaction.A 15-month-old boy was admitted to our institution with a history of recurrent vomiting and diarrhea for 7 days and fever for 2 days. Abdominal distention was found upon physical examination but other congenital anomalies were not. He was initially treated for acute gastroenteritis, but vomiting resumed after starting oral ingestion. Congenital membranous duodenal stenosis and impaction of a shimeji mushroom into the narrow section of the duodenum was recognized upon endoscopy. Dilatation was successful and restenosis was not seen. Food impaction is a rare (but important) initial event in congenital duodenal stenosis, and this disorder should be included in the differential diagnosis, especially for infants/toddlers with recurrent vomiting that develops at the time of eating solid and more diverse types of food.

摘要

十二指肠狭窄是一种先天性肠道闭锁综合征。大多数患者在新生儿期因反复呕吐而被诊断出来,但有些病例在年龄较大时才出现症状。我们报告一例具有不寻常致病机制的病例:因食物嵌塞导致的突发性肠梗阻。一名15个月大的男孩因反复呕吐和腹泻7天、发热2天入院。体格检查发现腹胀,但未发现其他先天性异常。他最初接受急性胃肠炎治疗,但开始口服摄入后呕吐再次出现。内镜检查发现先天性膜性十二指肠狭窄,且白玉菇嵌塞在十二指肠狭窄段。扩张成功,未见再狭窄。食物嵌塞是先天性十二指肠狭窄中罕见(但重要)的初始事件,这种疾病应列入鉴别诊断,尤其是对于在进食固体及更多种类食物时出现反复呕吐的婴幼儿。

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