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床旁超声在小儿多部位乳糜性积液诊断与处理中的应用价值

Usefulness of Point-Of-Care Ultrasound in Diagnosing and Managing Pediatric Multidistrict Chylous Effusion.

作者信息

Bellini Tommaso, Bustaffa Marta, Crocco Marco, Casabona Federica, Iovinella Giorgia, Malerba Federica, D'Alessandro Matteo, Piccotti Emanuela

机构信息

Pediatric Emergency Room and Emergency Medicine Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy.

Pediatric Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy.

出版信息

Reports (MDPI). 2024 Dec 5;7(4):110. doi: 10.3390/reports7040110.

Abstract

: The use of point-of-care ultrasound (POCUS) in emergency departments is rapidly growing due to its ability to provide immediate and accurate diagnostic information at the bedside. Furthermore, it can provide precise and rapid information on the location of multidistrict effusions in patients with suspected lymphatic decompensation. : This unique clinical case report describes a patient who presented with massive, multidistrict chylous effusion secondary to acute lymphatic insufficiency, a rare and challenging condition. Due to a recent diagnosis of celiac disease, the patient had started a gluten-free diet ten days before the onset of symptoms, suggesting a possible causal link. Through comprehensive thoracoabdominal POCUS, the diagnosis was made promptly, avoiding delays in treatment and enabling timely decision-making. : This case emphasizes the critical role of POCUS not only in expediting diagnosis but also in guiding invasive procedures, such as thoracentesis, by visualizing fluid accumulation and anatomical structures in real-time. Moreover, POCUS provides an invaluable tool for ongoing clinical ultrasound follow-up, facilitating continuous monitoring without exposing the patient to the risks of radiation, thus optimizing patient care and resource utilization.

摘要

由于能够在床边提供即时且准确的诊断信息,床旁超声(POCUS)在急诊科的应用正在迅速增长。此外,它可以为疑似淋巴代偿失调患者的多部位积液位置提供精确且快速的信息。:本独特的临床病例报告描述了一名因急性淋巴功能不全继发大量多部位乳糜胸的患者,这是一种罕见且具有挑战性的病症。由于近期诊断为乳糜泻,患者在症状出现前十天开始了无麸质饮食,提示可能存在因果关系。通过全面的胸腹部POCUS,迅速做出了诊断,避免了治疗延误并实现了及时决策。:该病例强调了POCUS的关键作用,不仅在于加快诊断,还在于通过实时可视化液体聚集和解剖结构来指导侵入性操作,如胸腔穿刺术。此外,POCUS为持续的临床超声随访提供了宝贵工具,便于持续监测而无需让患者承受辐射风险,从而优化患者护理和资源利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b58/12199954/3664e5287c9a/reports-07-00110-g001.jpg

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