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先天性囊性腺瘤样畸形——误诊的风险:一例病例报告

Congenital cystic adenomatoid malformation - dangers of misdiagnosis: a case report.

作者信息

El Amraoui Wafae, Bentalha Aziza, Hamri Hajar, Es-Chrif El Kettani Salma, El Koraichi Alae

机构信息

Faculty of Medicine, University Mohammed 5, Rabat, Morocco.

Department of Anesthesiology, Hopital d'enfants de Rabat, Rabat, Morocco.

出版信息

J Med Case Rep. 2017 Aug 4;11(1):212. doi: 10.1186/s13256-017-1349-5.

Abstract

BACKGROUND

Congenital cystic adenomatoid malformation is a rare pulmonary malformation, but is the most common lung malformation observed in children. In developing countries, such as Morocco, prenatal diagnosis is missing. Congenital cystic adenomatoid malformation may occur after birth in the presence of complications and needs a computed tomography scan for confirmation. However, our lack of awareness of this malformation has been responsible for a late and wrong diagnosis along with therapeutic errors. We report the first case in Morocco where diagnosis is confirmed by histology after death.

CASE PRESENTATION

A 10-month-old Arab boy was prescribed various antibiotics (including anti-staphylococcal) and endured repeated chest drainages, leading to his death just after radiological diagnosis and instant surgery.

CONCLUSIONS

The goal of this case report is to firmly express the need for both pediatricians and radiologists to enlarge diagnosis investigations, especially of congenital or constitutional entities in children, as soon as recurrence of respiratory distress and pulmonary infections are manifested. We also emphasize this important entity because of its frequency, to avoid the eventual therapeutic errors.

摘要

背景

先天性囊性腺瘤样畸形是一种罕见的肺部畸形,但却是儿童中最常见的肺部畸形。在摩洛哥等发展中国家,产前诊断尚付阙如。先天性囊性腺瘤样畸形在出现并发症时可能在出生后发生,需要进行计算机断层扫描以确诊。然而,我们对这种畸形缺乏认识导致了诊断延迟和错误,以及治疗失误。我们报告了摩洛哥首例经死后组织学确诊的病例。

病例介绍

一名10个月大的阿拉伯男孩被使用了各种抗生素(包括抗葡萄球菌药物),并经历了多次胸腔引流,在放射学诊断和即刻手术后不久死亡。

结论

本病例报告的目的是明确指出,一旦出现呼吸窘迫和肺部感染复发,儿科医生和放射科医生都有必要扩大诊断检查范围,尤其是针对儿童的先天性或体质性疾病。我们还强调了这一重要疾病的发病率,以避免可能出现的治疗失误。

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