兒童期的植物糞石九病例報告

Phytobezoar in Children: Nine Cases Report

蔡淳娟(Tsuen-Chiuen Tsai) ； 黃富源(Fu-Yuan Huang) ； 李宏昌(Hung-Chang Lee) ； 邱世昌(Shr-Chang Chyou) ； 葉明倫(Ming-Lung Yeh)

《Acta Paediatrica Sinica》 25卷4期 (1984/12) Pp. 434-438

摘要

馬偕紀念醫院小兒科自民國63年至72年，10年間共經驗植物性糞石(phytobezoar)9例，玆就其發病原因，臨床表徵、各種檢查、治療與預後，做一分析與探討。在這9例中，7例爲男性，2例爲女性；病童年齡分佈從6個月到10歲10個月；主要臨床表徵爲急性腹痛、嘔吐和腹脹，僅1例有發燒現象；病史中食用過柿子者僅2例，均無異食癖，且智力正常；身體檢查均有腹脹和壓痛，摸到腹內質塊者2例，出現反彈壓痛者2例；實驗室檢查，僅1例呈白血球增加，腹部X光攝影，均呈腸阻塞現象，有氣體液界面。8例於剖腹探查術中發現質塊，其中6例取出質塊經病理證實爲植物性糞石，1例沒有開刀，而死於腸阻塞及蛔蟲纏繞會厭引起的窒息，經病理解剖證實爲性糞石。阻塞部位，9例均分佈於小腸。前8例手術後均康復出院。

並列摘要

Nine cases of phytobezoar in children are reported. Seven were boys and two girls. The youngest was 6 months old and the oldest was 11 years. There were only two cases with definite histories of ingestion of persimmons. They were all mentally normal. The main symptoms were acute abdominal pain, vomiting and abdominal distention. The duration ranged from 2 days to 10 days. Fever was absent. In all cases except in one who suffered from pneumonia simultaneously. On physical examination, an abdominal mass was detected in 2 cases and rebound tenderness in 2 cases. X-ray films revealed diffuse small intestinal dilatation with multiple air-fluid levels. Exploration of the abdomen in 8 cases revealed intraluminal masses and six cases were proved to be phytobezoars. The sites of obstruction were all at small intestines. All of them recovered uneventfully except one patient who was suffocated with an ascaris worm in the glottic area and expired.

並列關鍵字

intestinal obstruction ； phytobezoar