Gu Chunhui, Zhang Youcheng, Jiang Guoqing, Hu Xiaoting
Huai'an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai'an, China.
Hepatobiliary Surgery, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Front Pediatr. 2024 Dec 19;12:1503456. doi: 10.3389/fped.2024.1503456. eCollection 2024.
This case report describes a rare instance of small bowel obstruction (SBO) caused by the ingestion of a whole Shine-Muscat grape in a 7-month-old infant. This case adds to the scientific literature by highlighting the potential risk of common fruits, such as grapes, in causing serious gastrointestinal blockages in pediatric patients, which is an uncommon but important consideration for pediatricians and caregivers.
A 7-month-old female presented with a 3-day history of vomiting, which progressed to bilious vomiting, accompanied by abdominal distension and dehydration. Abdominal CT imaging revealed dilated small bowel loops and a spherical low-density lesion suggestive of an obstructing foreign body.
The diagnosis of mechanical small bowel obstruction due to a foreign body was confirmed intraoperatively. The obstructing object was identified as a whole Shine-Muscat grape. Surgical management involved a minimally invasive laparoscopic approach to crush and move the grape into the colon, avoiding bowel incision. The patient recovered well postoperatively and passed the grape fragments naturally, resuming a normal diet within days.
This case underscores the importance of considering fruit ingestion as a potential cause of intestinal obstruction in infants. Pediatric surgeons and emergency clinicians should be aware of this rare but significant risk and employ careful history-taking, appropriate imaging, and minimally invasive techniques to manage such cases effectively.
本病例报告描述了一名7个月大婴儿因吞食一整颗阳光玫瑰葡萄而导致小肠梗阻(SBO)的罕见病例。该病例通过强调葡萄等常见水果在导致儿科患者严重胃肠道梗阻方面的潜在风险,丰富了科学文献,这对儿科医生和护理人员来说是一个虽不常见但重要的考虑因素。
一名7个月大的女性患儿出现了3天的呕吐病史,随后发展为胆汁性呕吐,并伴有腹胀和脱水。腹部CT成像显示小肠肠袢扩张,有一个球形低密度病变,提示存在阻塞性异物。
主要诊断、治疗干预及结果:术中证实为异物导致的机械性小肠梗阻。阻塞物体被确定为一整颗阳光玫瑰葡萄。手术治疗采用微创腹腔镜方法,将葡萄压碎并移入结肠,避免肠道切开。患者术后恢复良好,葡萄碎片自然排出,数天内恢复正常饮食。
本病例强调了将水果摄入视为婴儿肠梗阻潜在原因的重要性。小儿外科医生和急诊临床医生应意识到这种罕见但重大的风险,并通过仔细询问病史、进行适当的影像学检查以及采用微创技术来有效处理此类病例。