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一名14岁男性的乙状结肠扭转,表现类似急性肠胃炎。

Sigmoid volvulus in a 14-year-old male mimicking acute gastroenteritis.

作者信息

Senanayake Tharindu, McEwen Ellie C, Naidoo Taryn, Al-Mahaidi Senan, Al-Mahaidi Saad

机构信息

Surgical and Perioperative Care Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.

Manning Base Hospital, Hunter New England Health, Taree, NSW, Australia.

出版信息

J Surg Case Rep. 2023 Mar 25;2023(3):rjad166. doi: 10.1093/jscr/rjad166. eCollection 2023 Mar.

Abstract

Sigmoid volvulus is a rare but life-threatening diagnosis in the paediatric population and has only been reported a handful of times in the literature. We describe the case of a 14-year-old boy with abdominal pain and diarrhoea who was diagnosed with a sigmoid volvulus after initially being managed for infectious gastroenteritis. The patient initially presented with a 5-day history of watery stool, 1-day history of profuse vomiting and colicky abdominal pain. Whilst admitted, the patient developed worsening abdominal pain, distention and hyperresonance to percussion. Computed tomography demonstrated a dilated sigmoid colon, with a mesenteric 'whirl sign' around the inferior mesenteric artery. The patient underwent a laparotomy, which confirmed a sigmoid volvulus, requiring an anterior resection. This case emphasises the importance for general surgeons to consider the rare diagnosis of sigmoid volvulus in children.

摘要

乙状结肠扭转在儿科人群中是一种罕见但危及生命的诊断,在文献中仅有少数病例报道。我们描述了一名14岁腹痛和腹泻男孩的病例,该男孩最初因感染性肠胃炎接受治疗,后被诊断为乙状结肠扭转。患者最初表现为5天的水样便病史、1天的大量呕吐和绞痛性腹痛。入院期间,患者出现腹痛加剧、腹胀和叩诊呈鼓音。计算机断层扫描显示乙状结肠扩张,肠系膜下动脉周围有肠系膜“漩涡征”。患者接受了剖腹手术,证实为乙状结肠扭转,需要进行前切除术。该病例强调了普通外科医生考虑儿童罕见的乙状结肠扭转诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fcc/10039753/70e31625ee76/rjad166f1.jpg

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