El Hasbaoui Brahim, Karboubi Lamia, Benjelloun Badr Sououd
Paediatric Medical Emergency Department, Children's Hospital, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.
Pan Afr Med J. 2018 May 28;30:68. doi: 10.11604/pamj.2018.30.68.12058. eCollection 2018.
Excessive or persistent crying is a common presentation to the pediatric emergency department, and often poses a diagnostic dilemma to emergency physicians. There are several reasons for excessive or persistent crying in children, ranging from benign causes like hunger, to life-threatening causes such as intussusception. The objective of this work is to specify the place of abdominal ultrasound in the diagnosis and management of incessant cries in the infant. A cross sectional investigation for 3 months about cases of infants admitted for excessive or persistent crying to the paediatric emergency medical department of the Rabat Children's Hospital. Thirty-nine cases of excessive crying. The average age of our patients was 5.7 months with a male predominance. The incessant cries constituted the main reason for consultation in all our patients. The abdominal ultrasound performed in all the patients and revealed six cases of "Intestinal intussusception, eight cases of colic with distention gas, one case of uretero-hydronephrosis, one case with lymphadenitis mesenteric whereas it was normal in twenty-three cases. Children presenting with excess or persistent crying with no clear historical and physical examination clues, pose a diagnostic challenge to emergency physicians. This survey illustrates that despite the fact that abdominal ultrasound was normal in 58% of the cases, it made possible to make an early diagnosis of 15% of acute intestinal intussusception and it has become the gold standard in management of excessive crying in infants.
过度哭闹或持续性哭闹是儿科急诊科常见的症状表现，常常给急诊医生带来诊断难题。儿童过度哭闹或持续性哭闹有多种原因，从饥饿等良性原因到肠套叠等危及生命的原因都有。这项研究的目的是明确腹部超声在婴儿持续性哭闹的诊断和管理中的作用。对拉巴特儿童医院儿科急诊医学部收治的因过度哭闹或持续性哭闹入院的婴儿病例进行了为期3个月的横断面调查。共39例过度哭闹病例。我们的患者平均年龄为5.7个月，以男性为主。持续性哭闹是所有患者就诊的主要原因。对所有患者均进行了腹部超声检查，结果显示6例肠套叠、8例胀气性绞痛、1例输尿管肾盂积水、1例肠系膜淋巴结炎，23例结果正常。对于那些过度哭闹或持续性哭闹且无明确病史和体格检查线索的儿童，给急诊医生带来了诊断挑战。这项调查表明，尽管58%的病例腹部超声结果正常，但它仍能早期诊断出15%的急性肠套叠，并且已成为婴儿过度哭闹管理的金标准。
