Emergency Department, Naval Medical Center San Diego, San Diego, California (Ms Gerhart); Emergency Department, Scripps Memorial Hospital La Jolla, California (Dr Dickson); and Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, California (Dr Hoyt).
Adv Emerg Nurs J. 2021;43(1):21-27. doi: 10.1097/TME.0000000000000332.
This is the case of a 9-month-old female infant who presented to the emergency department with a history of several episodes of nonbilious and nonbloody emesis. The patient was found to be afebrile with normal vital signs and an otherwise normal physical examination. Initial plain film radiography was concern for possible obstruction. Imaging studies with ultrasonogram demonstrated intussusception. This was an unusual case of intussusception because children are typically more ill-appearing with vomiting, diarrhea, fevers, lethargy, and blood in stool. Management options included surgery, pneumatic enema reduction, and barium enema reduction. Pneumatic enema reduction was performed. This procedure has been shown to have superior outcomes in infants with intussusception. Advanced practice providers need to provide a detailed history, complete a thorough physical examination, order the appropriate diagnostics, and be vigilant of the clinical manifestation of intussusception.
这是一例 9 个月大女婴的病例，因多次非胆汁性、非血性呕吐到急诊科就诊。患儿无发热，生命体征正常，体格检查未见其他异常。初始的平片放射检查提示可能存在梗阻。超声检查显示肠套叠。这是一例不常见的肠套叠病例，因为儿童通常会出现呕吐、腹泻、发热、嗜睡和粪便带血等更严重的症状。治疗选择包括手术、气钡灌肠复位和空气灌肠复位。进行了空气灌肠复位。该操作已被证明在肠套叠患儿中具有更好的效果。高级执业医师需要提供详细的病史、完成全面的体格检查、选择适当的诊断方法，并警惕肠套叠的临床表现。
