非新生儿期自发性胃破裂

V. Mišanović, E. Begić
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摘要

这项研究旨在展示一名3岁女孩的自发性胃破裂。患者因全身状况不佳,突然出现剧烈腹痛、呕吐,并发低血容量性休克(血压无法测量,呈酸中毒),入院后6小时内由儿科外科医生行手术。术中发现胃大血管多处胃黏膜缺损伴跨壁出血,肌层无病理组织学改变。在儿童重症监护病房继续治疗,出现限制生命的并发症:腹膜炎、败血症、颅内出血和死亡。急性胃胀引起的胃破裂在新生儿期以外罕见,临床病程快,死亡率高。早期诊断和快速的外科手术是避免发展导致致命结果的限制生命的并发症的先决条件。
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Spontaneous rupture of the stomach in nonneonatal period
This study aimed to show the spontaneous rupture of the stomach in a 3-year-old girl. The patient was admitted to the pediatric clinic due to poor general condition that occurred suddenly with severe abdominal pain, vomiting, and the development of hypovolemic shock (blood pressure was unmeasurable, in acidosis), and after the ultrasound and abdominal X-ray, she was operated by the pediatric surgeon within 6 h of admission. During surgery, multiple defects of stomach mucosa with transmural bleeding without pathohistological changes in the muscle layer were found in the large stomach blood vessels. Treatment was continued in the pediatric intensive care unit with the development of life-limiting complications: peritonitis, sepsis, intracranial hemorrhage, and outcome of death. Rupture of the stomach caused by acute distension is rarely seen outside the neonatal period with fast clinical course and high mortality rate. Early diagnosis and rapid surgical procedures are a prerequisite to avoid the development of life-limiting complications that lead to a fatal outcome.
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