Knudson M
Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
Postgrad Med. 1988 Jun;83(8):201-2, 207-10, 212. doi: 10.1080/00325481.1988.11700316.
Intussusception is an uncommon condition, but it is the most frequent cause of bowel obstruction in infants and children aged 3 months to 5 years. If undiagnosed, it can result in bowel necrosis, perforation, and even death. Four cardinal signs and symptoms (abdominal pain, rectal bleeding, vomiting, and abdominal mass) are described in patients with intussusception, but these manifestations are not always present and their absence may lead to misdiagnosis. Lethargy might be considered a fifth cardinal symptom. As demonstrated in this case, lethargy may be a significant presenting feature in an infant with no history of abdominal pain, and in association with the other cardinal symptoms, it may be an early indication of a significant illness such as intussusception. Awareness of this association may result in an earlier diagnosis and an improved outcome in patients with intussusception.
肠套叠是一种少见的病症，但它是3个月至5岁婴幼儿肠梗阻最常见的病因。如果未被诊断出来，它可导致肠坏死、穿孔，甚至死亡。肠套叠患者有四大主要体征和症状（腹痛、直肠出血、呕吐和腹部肿块），但这些表现并非总是出现，而它们的缺失可能导致误诊。嗜睡可能被视为第五大主要症状。如本病例所示，嗜睡可能是一名无腹痛病史婴儿的重要表现特征，并且与其他主要症状相关联时，它可能是诸如肠套叠等重大疾病的早期迹象。认识到这种关联可能会使肠套叠患者得到更早的诊断并改善其预后。
