摘要
目的探讨儿童过敏性紫癜合并急性坏死性胰腺炎的临床特点，为过敏性紫癜合并急腹症提供诊断和鉴别诊断思路。方法分析郑州大学第一附属医院儿科收治的1例临床表现为紫癜、腹痛、大量腹水、精神差患儿的临床表现及检查结果。请小儿肾脏内科、小儿外科、小儿消化内科医师进行查房讨论，根据讨论意见调整治疗方案，追踪其治疗效果及预后。结果该病例入院时初步诊断为过敏性紫癜、急性弥散性腹膜炎原因待查，经多学科会诊后考虑外科急腹症不能排除，急性胰腺炎需进一步鉴别，查房后病情变化先予腹腔镜手术探查，术中发现坏死胰腺组织，证实为急性坏死性胰腺炎，术后内科治疗效果良好。结论临床工作中过敏性紫癜合并急腹症除需与肠套叠、肠穿孔、肠坏死等相鉴别，还应警惕临床少见的急性坏死性胰腺炎。
Objective To explore the clinical characteristics of Henoch -Schonlein purpura complicated with acute necrotizing acute pancreatitis, in order to provide information for the diagnosis and differentiation of Henoch - Schonlein purpura complicated with acute abdominal disease. Methods There was a case present with purpura, abdominal pain ,massive ascites and poor spirit in Department of Pediatrics ,the First Affihated Hospital of Zhengzhou University. The clinical manifestations and physical examination results were summarized and discussed, some pediatric specialists from nephrology department, surgery department, digestive system department were invited to discuss the case. The treatment was adjusted according to result of discussion, the final diagnosis was tracked. Results The case was firstly diagnosed with Henoch - Sch0nlein purpura, acute diffuse peritonitis with cause in dispute. After the discussion, the intestinal necrosis, perforation could not be excluded, acute pancreatitis required further identification. Exploratory laparotomy was received because of the changing condition after discussion. The intraoperative diagnosis was acute necrotizing pancreatitis. The patient recovered well with medical treatment. Conclusion When children with Henoch - Schonlein purpura had an acute abdominal disease,acute necrotizing pancreatitis should be considered in addition to intestinal necrosis, perforation.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2017年第5期380-383,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
紫癜
坏死性胰腺炎
腹痛
腹水
Purpura
Necrotizing pancreatitis
Abdominal pain
Ascites
