Cheng Xueliang, Qu Yang, Dong Rongpeng, Yang Lili, Kang Mingyang, Zhao Jianwu
The 2nd Hospital of Jilin University, Changchun, Jilin, People's Republic of China.
Medicine (Baltimore). 2020 Aug 14;99(33):e21762. doi: 10.1097/MD.0000000000021762.
There have been few case reports of abdominal pain as a symptom of spontaneous intraspinal hemorrhage. We herein describe a case involving a girl with paraplegia caused by spontaneous epidural hemorrhage in the thoracic spinal canal, characterized by abdominal pain.
An 8-year-old girl with sudden abdominal pain and back pain was misdiagnosed as having an abdominal disease until she had the symptom of paralysis.
The patient was diagnosed with spontaneous intraspinal hemorrhage masquerading as atypical abdominal pain.
When the patient developed symptoms of lower extremity paralysis, thoracic magnetic resonance imaging was performed and epidural hemorrhage was found in the thoracic spinal canal. Surgical treatment was performed after the diagnosis was confirmed.
The patient could almost walk normally after 3 months. One year after surgery, the Frankel grade of spinal cord function was grade D. We continued to follow-up this patient.
The symptoms caused by intraspinal hemorrhage are mainly back pain with or without neurological dysfunction. However, sometimes atypical symptoms, such as abdominal and chest pain, can be identified in clinical settings. Emergency surgery is recommended as the treatment of choice for intraspinal hemorrhage with neurological dysfunction.
作为自发性椎管内出血症状的腹痛病例报告较少。我们在此描述一例因胸段椎管内自发性硬膜外出血导致截瘫的女孩病例，其特征为腹痛。
一名8岁女孩突发腹痛和背痛，在出现瘫痪症状之前被误诊为患有腹部疾病。
该患者被诊断为伪装成非典型腹痛的自发性椎管内出血。
当患者出现下肢瘫痪症状时，进行了胸椎磁共振成像检查，发现胸段椎管内硬膜外出血。确诊后进行了手术治疗。
患者在3个月后几乎可以正常行走。术后1年，脊髓功能Frankel分级为D级。我们继续对该患者进行随访。
椎管内出血引起的症状主要是背痛，伴有或不伴有神经功能障碍。然而，在临床环境中有时可以识别出非典型症状，如腹痛和胸痛。对于伴有神经功能障碍的椎管内出血，建议首选急诊手术治疗。
