Wi Seol Woo, Lee Su Jin, Kang Eun Kyeong, Cho Sung Min
Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2017 Jun;20(2):130-133. doi: 10.5223/pghn.2017.20.2.130. Epub 2017 Jun 28.
Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.
自分子诊断技术出现以来,诺如病毒已被确认为流行性和散发性胃肠炎的主要病因。在因胃肠炎住院的儿科患者中,有5%-31%的病例记录了诺如病毒感染。虽然诺如病毒胃肠炎通常症状较轻且具有自限性,但在免疫功能低下患者、幼儿和老年人等易感人群中,它会导致严重甚至有时致命的情况。诺如病毒感染导致的肠穿孔很少见。我们报告一例唐氏综合征婴儿在肺炎住院期间发生诺如病毒胃肠炎伴小肠穿孔的病例。严重脱水可能导致肠缺血,在本病例中可能引发了肠穿孔。医生应警惕严重急性腹泻后可能出现的手术并发症,尤其是在高危人群中。