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病例10-2017:一名胃肠出血和腹痛的6月龄男婴
Case 10-2017 — A 6-Month-Old Boy with Gastrointestinal Bleeding and Abdominal Pain


Lauren M. Allister ... 其他 • 2017.03.30

病例陈述


Akash Gupta医师(内科和儿科):一名6月龄男婴因胃肠出血和腹痛被送到本院急诊科就诊。

就诊前2日,患儿的父母注意到他开始出现间歇性腹痛,而患儿的健康状况在此前一直正常。腹痛发作时患儿啼哭,平躺时会将双腿向胸部屈曲,有时患儿睡眠中会因腹痛醒来。患儿父母说,有时腹痛发作中他们触摸了患儿的腹部,感觉腹部僵硬;怀疑他可能因肠道内气体过多感到不适。患儿继续正常饮食,未出现呕吐。第二日,患儿排便2次,粪便微红。第一次排便时,似乎只有少量红色存在,且只出现在粪便的表面;第二次排便红色的量增加。患儿的母亲认为粪便变色是因为患儿食用了甜菜,因为以前患儿食用甜菜后也出现过粪便微红。间歇性明显腹痛继续出现,但患儿在发作间期表现正常。在就诊当日早晨,他第三次出现粪便微红。他的父母将他送往日托,日托期间他继续偶有啼哭和疼痛,之后的一次排便看起来几乎全部是血液,其中有一个大的血块。据称他这次排便后面色苍白、发汗。日托保育员打电话通知了患儿的母亲,患儿母亲将患儿送往另一家医院的急诊科。





作者信息

Lauren M. Allister, M.D., Ruth Lim, M.D., Allan M. Goldstein, M.D., and Jochen K. Lennerz, M.D.
From the Departments of Emergency Medicine (L.M.A.), Radiology (R.L.), Surgery (A.M.G.), and Pathology (J.K.L.), Massachusetts General Hospital, and the Departments of Emergency Medicine (L.M.A.), Radiology (R.L.), Surgery (A.M.G.), and Pathology (J.K.L.), Harvard Medical School — both in Boston.

 

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