儿童克罗恩病以外阴阴道症状首发 1 例报告。
Vulvovaginal Complaints as the First Manifestation of Crohn's Disease in Children: Case Report.
机构信息
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale New Haven Hospital, New Haven, Connecticut.
Department of Gastroenterology, Hepatology, and Nutrition, Yale New Haven Hospital, New Haven, Connecticut.
出版信息
J Pediatr Adolesc Gynecol. 2023 Oct;36(5):494-496. doi: 10.1016/j.jpag.2023.05.007. Epub 2023 May 15.
BACKGROUND
Crohn's disease, a chronic gastrointestinal inflammatory condition, can involve gynecological structures. Rectovaginal or rectovestibular involvement may be the first sign in the pediatric population and may result in delayed diagnosis and treatment.
CASE
A 9-year-old premenarchal female with chronic constipation and poor growth presented to the pediatric gynecologist for evaluation of persistent vulvovaginal discharge and vulvar irritation. Examination under anesthesia revealed a rectolabial fistula; colonoscopy was diagnostic of Crohn's disease. Immunotherapy resulted in improvement of symptoms and anatomical changes.
SUMMARY AND CONCLUSION
In cases of persistent vulvar complaints in a child without clear diagnosis, a high index of suspicion for a non-gynecologic diagnosis is necessary. Collaboration between pediatric gynecologists, gastroenterologists, and surgeons can result in prompt diagnosis and treatment of genital Crohn's disease.
背景
克罗恩病是一种慢性胃肠道炎症性疾病，可累及妇科结构。直肠阴道或直肠前庭受累可能是儿科人群的首发症状，并可能导致诊断和治疗延迟。
病例
一名 9 岁的初潮前女性，有慢性便秘和生长不良，因持续性外阴阴道分泌物和外阴刺激而就诊于小儿妇科医生。全身麻醉下检查发现直肠会阴瘘；结肠镜检查诊断为克罗恩病。免疫治疗改善了症状和解剖结构。
总结和结论
对于无明确诊断的持续性外阴不适的患儿，需要高度怀疑非妇科诊断。小儿妇科医生、胃肠病学家和外科医生之间的合作可以实现对生殖器克罗恩病的快速诊断和治疗。
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