Schneeweiss Garber Natalie, Bourgade Su Paul A, Lozano Guerrero Gretel, Hernandez Salazar Andrea, Aboitiz Carlos Manuel
Faculty of Health Sciences, Universidad Anáhuac México, Mexico City, MEX.
Pediatrics, Hospital Angeles Pedregal, Mexico City, MEX.
Cureus. 2024 Aug 31;16(8):e68340. doi: 10.7759/cureus.68340. eCollection 2024 Aug.
Abdominal pain stands as one of the foremost reasons for consultation among pediatric patients, presenting a diagnostic challenge owing to its diverse underlying causes. The manifestation of abdominal pain varies according to age, associated symptoms, and pain localization. While frequently self-limited, certain conditions exist that endanger life and require urgent intervention. Acute abdomen denotes severe, non-traumatic abdominal pain resulting from inflammatory, ischemic, obstructive, infectious, gynecological, or metabolic etiologies, warranting immediate therapeutic intervention. Infectious processes that mimic acute abdominal conditions are relatively uncommon. Consequently, the identification of infectious gastroenteritis as a probable etiology of acute abdomen can prevent unnecessary surgical interventions in patients. This report details two cases: a 14-year-old pediatric patient presenting with acute abdominal pain, in whom appendiceal involvement was ruled out through ultrasonographic and computed tomography (CT) examinations, confirming the presence of enteroaggregative , and a 10-year-old pediatric patient presenting with a sudden onset of abdominal pain. CT findings revealed an appendiceal fecalith without concurrent inflammation but accompanied by mesenteric adenitis. Even though conservative treatment did not improve the pain, it was later determined that the patient was a carrier of enteroinvasive . In both cases, antimicrobial treatment with rifaximin 200 mg every eight hours was administered, leading to the resolution of the conditions without the need for hospital readmission or additional therapy. Infectious conditions stemming from enteroaggregative and enteroinvasive can mimic acute abdomen and should be regarded as potential infectious etiologies when other more common causes have been ruled out.
腹痛是儿科患者就诊的首要原因之一，因其潜在病因多样，故而构成诊断难题。腹痛的表现因年龄、伴随症状及疼痛部位而异。虽然腹痛通常为自限性，但某些情况会危及生命，需要紧急干预。急腹症指由炎症、缺血、梗阻、感染、妇科或代谢性病因引起的严重非创伤性腹痛，需要立即进行治疗干预。模拟急腹症的感染性疾病相对少见。因此，将感染性肠胃炎确定为急腹症的可能病因，可避免对患者进行不必要的手术干预。本报告详细介绍两例病例：一名14岁儿科患者出现急性腹痛，经超声和计算机断层扫描（CT）检查排除阑尾病变，确诊为集聚性肠杆菌感染；另一名10岁儿科患者突然腹痛。CT检查发现阑尾粪石，无并发炎症，但伴有肠系膜腺炎。尽管保守治疗未能缓解疼痛，但后来确定该患者为侵袭性肠杆菌携带者。两例均每八小时给予200毫克利福昔明进行抗菌治疗，病情得以缓解，无需再次入院或接受额外治疗。由集聚性肠杆菌和侵袭性肠杆菌引起的感染性疾病可模拟急腹症，在排除其他更常见病因后，应将其视为潜在的感染性病因。
