Enterocolitis in a Child With Hirschsprung Disease
Enterocolitis in a Child With Hirschsprung Disease
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DOI：
10.1097/pec.0000000000001108
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发表时间：
2019-07-01
影响因子：
1.4
通讯作者：
Nguyen, Michael C.
中科院分区：
文献类型：
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作者：
Guillaume, Alexander W. D.;Miller, Andrew C.;Nguyen, Michael C.
先天性巨结肠是一种先天性畸形，可以通过手术矫正。然而，Hirschsprung相关性小肠结肠炎可能是危及生命的后遗症。关于有先天性巨结肠病史的患者发生小肠结肠炎和休克的风险，在急诊医学文献中发表的很少。我们描述的情况下，6个月大的男婴的历史，多次手术的先天性巨结肠病谁提出了一个看似良性的病毒性胃肠道疾病的急诊室。他的病情稳定，因此可以出院。然而，4天后，他因严重腹泻返回急诊科，随后被送入儿科重症监护室，以治疗小肠结肠炎和休克。借由这个病例报告，我们的目的是提高急诊医师对先天性巨结肠症严重且可能致命的并发症的认识。我们认为，这一单一的元素，病人的病史可以改变看似简单的病毒性胃肠道疾病的管理，而不是出院，这样的病人需要手术咨询，并可能入院密切监测和治疗。
Hirschsprung disease is a congenital abnormality that can be surgically corrected. However, Hirschsprung-associated enterocolitis can be a life-threatening sequela. Very little has been published in the emergency medicine literature about the risk of enterocolitis and shock in patients with a history of Hirschsprung disease. We describe the case of a 6-month-old male infant with a history of multiple surgeries for Hirschsprung disease who presented to the emergency department with a seemingly benign viral gastrointestinal illness. His stable condition led him to be discharged. However, 4 days later, he returned to the emergency department with severe diarrhea and was subsequently admitted to the pediatric intensive care unit for the management of enterocolitis and shock. With this case report, we aim to raise emergency physicians' awareness of the serious and possibly fatal complications of Hirschsprung disease. We argue that this single element of a patient's medical history can alter the management of seemingly simple viral gastrointestinal illnesses; rather than be discharged, such a patient requires surgical consultation and possibly admission for close monitoring and treatment.