Abstract:
A nine-year-old wheelchair-bound female with cerebral palsy and intellectual disability secondary to trafficking protein particle complex subunit 9 (TRAPPC9) mutation presented to the family medicine clinic after not having passed stool for six days. There was a history of chronic constipation. Examination revealed high-pitched \"tinkling\" bowel sounds; therefore, a plain abdominal X-ray was ordered to rule out the possibility of intestinal obstruction, which showed a large fecaloma in the rectum with dilated bowel loops proximal to it, signifying obstruction. This was successfully treated with the administration of a rectal enema and confirmed by a post-enema radiograph. Although rare in children, a fecaloma should be considered a cause of bowel obstruction, especially where there is a history of chronic constipation. A plain abdominal X-ray can be useful in diagnosing a fecaloma in pediatric cases.
摘要:
一名9岁的轮椅女性,患有脑瘫和智力障碍,继发于蛋白质颗粒复合物亚基9(TRAPPC9)突变,在六天没有通过粪便后被提交给家庭医学诊所。有慢性便秘病史。检查显示高音“叮当作响”的肠音;因此,进行了腹部X线平片检查以排除肠梗阻的可能性,显示直肠有一个大的粪便瘤,近端有扩张的肠环,表示阻碍。通过直肠灌肠剂成功治疗,并通过灌肠后的X光片证实。虽然在儿童中很少见,粪便瘤应该被认为是肠梗阻的原因,尤其是有慢性便秘史的地方.腹部X线平片可用于诊断小儿粪便瘤。