Forsyth James Michael, Muhammad Karim, Mahmood Khalid
Department of General Surgery, Tameside Hospital, Manchester, Tameside, UK.
BMJ Case Rep. 2015 Feb 26;2015:bcr2014209270. doi: 10.1136/bcr-2014-209270.
A 9-year-old girl was admitted under our general surgical team with 2 days of diffuse abdominal pain and vomiting. This was one of multiple admissions for similar symptoms over the past 5 years. She was feverish on admission but haemodynamically stable. On examination, she had a diffusely tender and hypersensitive abdomen, with no guarding or peritonism, and no palpable masses. Of note, the patient was very thin, with almost no body fat. Blood tests were otherwise normal, with a normal abdominal X-ray and abdominal ultrasound. She had undergone three previous abdominal ultrasounds over the past 5 years for similar symptoms, all of which were normal. Following this, CT revealed a diagnosis of superior mesenteric artery syndrome. The patient was transferred to our regional children's hospital for analgaesia, nasogastric decompression and nutritional supplementation. She made a swift improvement with plans for ongoing follow-up by the paediatric team.
一名9岁女孩因弥漫性腹痛和呕吐2天，由我们的普通外科团队收治入院。这是她在过去5年中因类似症状多次入院之一。入院时她发热，但血流动力学稳定。检查发现，她的腹部弥漫性压痛且超敏，无肌卫或腹膜炎体征，未触及肿块。值得注意的是，该患者非常消瘦，几乎没有体脂。血液检查其他方面正常，腹部X线和腹部超声检查也正常。在过去5年中，她因类似症状曾接受过三次腹部超声检查，结果均正常。此后，CT检查确诊为肠系膜上动脉综合征。该患者被转至我们地区的儿童医院进行镇痛、鼻胃管减压和营养补充。她恢复迅速，儿科团队计划对其进行持续随访。
