Department of Pediatrics, Lumbini Medical College and Teaching Hospital, Pravas, Palpa, Nepal.
Department of Radiology, Lumbini Medical College and Teaching Hospital, Pravas, Palpa, Nepal.
JNMA J Nepal Med Assoc. 2020 Jul 31;58(228):600-603. doi: 10.31729/jnma.5134.
Vomiting with failure to thrive in older children is a diagnostic challenge due to the diversity in the diagnosis. We report a case of a five-years-old girl with failure to thrive, history of recurrent vomiting and intermittent colicky pain abdomen since 45 days of life. Intestinal malrotation with Ladd's band was diagnosed based on clinical acumen, high- resolution computed tomography, barium follow through and intraoperative findings. Exploratory laparotomy with Ladd's procedure was performed under general anesthesia which showed malrotation at the duodenojejunal junction with a short route of mesentery with floating caecum with Ladd's band. Failure to thrive with malrotation of the gut in the older age group is rare in itself. As there are very few cases reported in this age group, so we undertook to report this case to increase the awareness of knowledge concerning the diagnosis and timely management to prevent the comorbidity of this condition.
年长儿童因未能茁壮成长而出现呕吐是一个具有挑战性的诊断问题,因为诊断的多样性。我们报告了一例 5 岁女孩,有生长不良、反复发作性呕吐和间歇性绞痛腹痛的病史,从出生后 45 天开始。基于临床敏锐性、高分辨率计算机断层扫描、钡剂透视和术中发现,诊断为肠旋转不良伴 Ladd 束带。在全身麻醉下进行剖腹探查和 Ladd 手术,显示十二指肠空肠交界处旋转不良,肠系膜短,游离盲肠伴有 Ladd 束带。年长儿童的肠道旋转不良伴生长不良本身就很少见。由于该年龄段报告的病例很少,因此我们报告这个病例是为了提高对诊断的认识,并及时进行管理,以预防这种疾病的并发症。