Divisions of Emergency Medicine and
Departments of Surgery and.
Pediatrics. 2019 Mar;143(3). doi: 10.1542/peds.2018-0504. Epub 2019 Feb 12.
A 2-year-old girl with a past medical history of cutaneous mastocytosis and eczema presented with 1 day of yellow-green, nonbloody vomiting, bradycardia, and listlessness. She was evaluated by her pediatrician and sent to the emergency department because of concern for dehydration. In the emergency department, she improved with fluid rehydration but still had decreased energy and bradycardia. Her electrocardiogram revealed sinus bradycardia, and laboratory results did not reveal any electrolyte abnormalities. Glucose levels were normal. An abdominal radiograph revealed a moderate-to-large stool burden, and the results of a computed tomography scan of the head were normal. An abdominal ultrasound was obtained to evaluate for intussusception. The ultrasound revealed a blind-ending tubular structure in the right-lower quadrant with adjacent free fluid, which was concerning for appendicitis. The patient was admitted to the surgical service for further management and was taken to the operating room, where a definitive diagnosis was made.
一名 2 岁女孩，既往有皮肤肥大细胞瘤和湿疹病史，因 1 天来黄绿色、非血性呕吐、心动过缓和无精打采就诊。她的儿科医生对其进行了评估，并因脱水的担忧而将其送往急诊部。在急诊部，她通过补液治疗后病情有所改善，但仍感到乏力和心动过缓。她的心电图显示窦性心动过缓，实验室结果未显示任何电解质异常。血糖水平正常。腹部 X 光片显示中等至大量粪便负荷，头部计算机断层扫描结果正常。进行了腹部超声检查以评估肠套叠。超声显示右下象限有一个盲端管状结构，伴有相邻的游离液体，这提示阑尾炎。该患者因进一步治疗而被收入外科病房，并被送往手术室，在那里做出了明确诊断。
