Schnedl Wolfgang J, Kalmar Peter, Mangge Harald, Krause Robert, Wallner-Liebmann Sandra J
Wolfgang J Schnedl, Practice for General Internal Medicine, A-8600 Bruck, Austria.
World J Gastroenterol. 2015 Sep 21;21(35):10242-5. doi: 10.3748/wjg.v21.i35.10242.
Unspecific abdominal complaints including bloating and irregular bowel movements may be caused by carbohydrate malabsorption syndromes, e.g., lactose and fructose malabsorption. These symptoms were investigated with hydrogen (H2) breath tests and correlated to carbohydrate malabsorption. During performing these H2-breath tests the patient presented with an acute, localized, non-migratory pain in the left lower abdominal quadrant. Primary epiploic appendagitis is a rare cause of abdominal acute or subacute complaints and diagnosis of primary epiploic appendagitis (PEA) is made when computed tomography reveals a characteristic lesion. We report on a patient with co-occurrence of lactose and fructose malabsorption, which was treated successfully with a diet free of culprit carbohydrates, with PEA recovering without medication or surgical treatment within few days. Since the abdominal unspecific symptoms had been present for months, they appeared not to be correlated to the acute localized abdominal pain, therefore we speculate on a random co-occurrence of combined carbohydrate malabsorption and PEA.
包括腹胀和排便不规律在内的非特异性腹部不适可能由碳水化合物吸收不良综合征引起，例如乳糖和果糖吸收不良。通过氢气（H2）呼气试验对这些症状进行了研究，并与碳水化合物吸收不良相关联。在进行这些H2呼气试验期间，患者左下象限出现急性、局限性、非游走性疼痛。原发性网膜附件炎是腹部急性或亚急性不适的罕见原因，当计算机断层扫描显示特征性病变时可诊断为原发性网膜附件炎（PEA）。我们报告了一名同时患有乳糖和果糖吸收不良的患者，该患者通过不含致病碳水化合物的饮食成功治疗，PEA在几天内无需药物或手术治疗即可康复。由于腹部非特异性症状已持续数月，它们似乎与急性局限性腹痛无关，因此我们推测碳水化合物吸收不良和PEA是随机同时出现的。
