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題 名 | Infantile Hypertrophic Pyloric Stenosis Presenting as Pseudo-Bartter's Syndrome and Seizures: Report of One Case=以假性巴特氏症候群及抽痙表現的嬰兒肥厚性幽門狹窄:一病例報告 |
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作 者 | 于鴻仁; 黃嵩雀; 謝志松; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷 期 | 39:3 民87.05-06 |
頁 次 | 頁195-197+214 |
分類號 | 417.54 |
關鍵詞 | 偽巴特氏症候群; 抽痙; 嬰兒肥厚性幽門狹窄; Pseudo-Bartter's syndrome; Seizure disorder; Infantile hypertrophic pyloric stenosis; |
語 文 | 英文(English) |
中文摘要 | 肥厚性幽門狹窄是一種嬰兒期常見的疾病。典型的病例、只需要藉由明顯的噴射 性嘔吐及觸診其上腹部發現橄欖狀硬塊即可診斷,而腹部超音波也有九成以上的診斷率。本 案例為一個兩個月大的男嬰,主訴有嘔吐、腹瀉且合併抽痙三天的的情形;入院當時評估其 有低血氯、低血鉀性鹼中毒及合併高腎激素、高醛類脂血症與血壓正常的情形,這些皆符合 特氏症候群( Barter's syndrome )的診斷標準。 在給予適當的體液補充及矯正電解質的 不平衡之後,我們為病人安排一些檢查。初次的腹部超音波檢查並未發現有明顯的病灶;而 在第二次的腹部超音波上及上消化道攝影則顯示有肥厚性幽門狹窄的情形。病人在接受幽門 環狀肌切開術後情況良好。 肥厚性幽門狹窄以偽巴特氏症候群( pesudo-Bartter's syndrome )及抽痙來表現是很少 見的。在文中除了對 Bartters syndrome 及 pesudo-Bartter's syndrome 之成因與機轉做 一番瞭解外,也對腹部超音波檢查的限制、上消化道攝影的適用情形及鑑別診斷之重要性做 一番探討。 |
英文摘要 | We report a hypertrophic pyloric stenosis case with an unusual inital presentation of seizures and Bartter's syndrome like symptoms. This case suffered from vomiting, diarrhea and poor appetite for several days, and seizures developed after these symptoms. From laboratory tests, hypochloremic and hypokalemic metabolic alkalosis associated with hyperreninemia, hyperaldosteronism and normal blood pressure were noted. Pseudo-Bartter's syndrome was diagnosed through these clinical and laboratory tests. Although the first abdominal echo was negative, we still speculated about the peculiar symptoms of vomiting and it's relationship to pseudo-Bartters syndrome. After all, we found the hypertrophic pyloric stenosis through an upper gastrointestinal series. From these experiences, we postulated that it's very important to put the hypertrophic pyloric stenosis into the differential diagnosis of pseudo-Batter's syndrome. |
本系統中英文摘要資訊取自各篇刊載內容。