Akalonu Amaka, Yasrebi Mona, Molle Rios Zarela
Division of Gastroenterology, Hepatology and Nutrition, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
Department of Medical Imaging, Alfred I. duPont Hospital for Children, Wilmington, DE, USA.
Am J Case Rep. 2016 Sep 30;17:694-698. doi: 10.12659/ajcr.898939.
BACKGROUND Spontaneous gastric perforation is a rare clinical disorder. The majority of the available data have been reported in the neonatal age group. There are a few cases of spontaneous gastric perforation in preschool children. To our knowledge, there is no published information on spontaneous gastric perforation in older children and adolescents. CASE REPORT We describe the presentation and clinical course of two adolescent children who presented with spontaneous gastric perforation. Both children presented with acute onset abdominal pain, which progressively worsened. In both cases, the patient were taken urgently to the operating room after imaging studies had shown pneumoperitoneum. In both cases, surgery revealed gastric perforation with no obvious etiology, specifically no -ulcer, inflammation, or other pathology. CONCLUSIONS These two cases highlight the importance of including spontaneous gastric perforation, not just the typical duodenal/gastric ulcer, in the differential of a patient with severe abdominal pain and distension, who has imaging showing pneumoperitoneum.
背景 自发性胃穿孔是一种罕见的临床病症。大多数现有数据是关于新生儿年龄组的报道。学龄前儿童中有少数自发性胃穿孔病例。据我们所知，尚无关于大龄儿童和青少年自发性胃穿孔的公开信息。病例报告 我们描述了两名患有自发性胃穿孔的青少年儿童的临床表现和临床病程。两名儿童均表现为急性腹痛，并逐渐加重。在这两个病例中，影像学检查显示气腹后，患者均被紧急送往手术室。在这两个病例中，手术均发现胃穿孔且无明显病因，具体而言没有溃疡、炎症或其他病变。结论 这两个病例凸显了在对有严重腹痛和腹胀且影像学显示气腹的患者进行鉴别诊断时，将自发性胃穿孔（而不仅仅是典型的十二指肠/胃溃疡）纳入考虑的重要性。
