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小儿脐肠系膜梗死:一种有效的诊断和治疗策略

Omental Infarction in a Child-Conservative Management as an Effective and Safe Strategy in Diagnosis and Treatment.

机构信息

Department of Pediatric and Oncological Surgery, Urology and Hand Surgery, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland.

出版信息

Int J Environ Res Public Health. 2021 Jul 29;18(15):8057. doi: 10.3390/ijerph18158057.

Abstract

Omental infarction (OI) is a rare disease occurring in children. Important risk factors include overweight and obesity. The clinical presentation is often non-specific, and the main symptom is acute abdominal pain. In addition, infarcted omentum may present with fever, anorexia, nausea, vomiting, diarrhea and dysuria. Due to the localisation of the pain, OI should be differentiated from acute appendicitis. The diagnosis of OI is sometimes made intraoperatively, during appendectomy for suspected acute appendicitis. Hence, it is important to state a correct preoperative diagnosis, which is commonly based on abdominal ultrasound and computed tomography. The treatment of OI is still inconclusive. Both conservative and surgical treatments are used. Both methods have their advantages and disadvantages. The decision of which treatment to follow should be multifactorial and include the patient's clinical condition at the time of admission, the progression or regression of symptoms during hospitalization and laboratory and imaging findings. We present a clinical case of a 9-year-old overweight girl with OI, whose diagnosis was based on imaging diagnostics and enabled conservative treatment with no complications. The case we have described confirms that the conservative treatment is an effective and safe therapy.

摘要

网膜梗死(OI)是一种罕见的儿科疾病。重要的危险因素包括超重和肥胖。临床表现通常不特异,主要症状为急性腹痛。此外,梗死的网膜可能出现发热、食欲不振、恶心、呕吐、腹泻和尿痛。由于疼痛的定位,OI 应与急性阑尾炎相鉴别。OI 的诊断有时是在怀疑急性阑尾炎而行阑尾切除术的手术过程中做出的。因此,术前做出正确的诊断非常重要,通常基于腹部超声和计算机断层扫描。OI 的治疗仍存在争议。保守治疗和手术治疗均有应用。两种方法各有优缺点。治疗方法的选择应综合考虑多种因素,包括入院时患者的临床状况、住院期间症状的进展或消退以及实验室和影像学检查结果。我们介绍了一例 9 岁超重女孩的 OI 临床病例,其诊断基于影像学诊断,并采用保守治疗,无并发症。我们所描述的病例证实了保守治疗是一种有效且安全的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a98/8345747/71f01f5fe2ad/ijerph-18-08057-g001.jpg

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