嬰兒幽門肥厚性狹窄之非典型例－三病例報告－

Atypical Presentations of Infantile Hypertrophic Pyloric Stenosis-Report of Three Cases-

李慧蘭(Huei-Lan Lee) ； 黃富源(Fu-Yuan Huang) ； 沈淵瑤(Yen-Yao Shen) ； 葉明倫(Ming-Lun Yeh) ； 陳秋江(Chiu-Chiang Chen)

《Acta Paediatrica Sinica》 27卷2期 (1986/04) Pp. 147-150

摘要

馬偕醫院自民國64年到74年共發現50例嬰兒幽門肥厚性狹窄。男女比例爲9比1。其中有3例出現非典型臨床表徵。第1例是剛生下第1天即出現症狀，於第6天即接受開刀手術。第2例是嘔吐物含有膽汁。第3例是個原本發育及餵食均佳的3個月大嬰兒，於入院前3天因腹瀉及嘔吐才發現。3個病例於開刀時在幽門處確均已形成肥厚性質塊，而且第2例另外還發現上段空腸受腹膜帶狀物壓迫而形成部分腸阻塞。3個病例手術後情況良好，經門診追蹤發育正常。

並列摘要

Infantile hypertrophic pyloric stenosis is well known to both pediatricians and pediatric surgeons for its classic clinical features of non-bilious emesis progressing to projectile vomiting, gastric peristalsis and epigastric mass in young infants. Of 50 infants with hypertrophic pyloric stenosis treated at the Mackay Memorial Hospital during the period 1975-1985, the diagnosis was readily made in 47 cases, but 3 cases with atypical presentations confused the diagnosis initially. The first case was a two-day-old female newborn who had vomited since birth. The second was a one-month-old male baby with bile-stained vomitus. The third was a rather wellnourished three-month-old male baby, admitted for diarrhea who had vomiting for three days without prior history of feeding problems. All three babies were proved at surgery to have hypertrophic pyloric stenosis. A peritoneal band compressing the upper jejunum was responsible for the bile-stained vomitus in the second case. The causes of very early or very late presentation of the disease are discussed.

並列關鍵字

infantile hypertrophic pyloric stenosis