• 文章类型: Case Reports
    最常见的先天性胃肠道异常是Meckel憩室。它在大多数情况下是偶然发现的。可以观察到胃肠道无痛出血。然而,偶尔会导致急性肠梗阻,这经常掩盖了实际的临床表现。这是一个四岁半的男孩,表现出阻塞的特征,which,关于进一步的评估,显示回肠肠套叠.计划进行紧急手术干预,进行剖腹探查术和肠套叠减少。该病例强调了诊断和管理肠套叠以防止肠缺血等严重后果的紧迫性。肠坏死,肠穿孔,腹膜炎,还有败血症.它强烈提醒医疗专业人员对这些严重的胃肠道紧急情况保持警惕,建议采用多学科方法立即治疗,以显著提高患者的预后.
    The most prevalent congenital gastrointestinal tract abnormality is Meckel\'s diverticulum. It is discovered in most instances incidentally. It can be observed as painless bleeding in the gastrointestinal tract. However, it can occasionally result in acute intestinal obstruction, which frequently masks the actual clinical presentation. This is a case of a four-and-a-half-year-old male child who presented with features of obstruction, which, on further evaluation, revealed ileoileal intussusception. An emergency surgical intervention was planned with an exploratory laparotomy and a reduction of intussusception. This case emphasizes the urgency of diagnosing and managing intussusception to prevent serious consequences such as bowel ischemia, bowel necrosis, bowel perforation, peritonitis, and sepsis. It stands as a stark reminder for medical professionals to stay vigilant for these critical gastrointestinal emergencies, and immediate treatment with a multidisciplinary approach is recommended to significantly enhance patient outcomes.
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  • 文章类型: Case Reports
    这项研究检查了一名4岁零1个月大的男性,没有明显的既往医学,家庭,或最初出现咳嗽的儿科诊所的手术史,鼻漏,结膜炎,呕吐,腿部和手臂疼痛,增加了走动的难度。该患者被转移到急诊科,检测为非COVID-19冠状病毒感染呈阳性。病人稳定下来了,给予静脉输液,并在第二天因头痛发作而出院返回诊所,右眼上睑下垂,无法承受重量,双侧上下肢无力导致共济失调步态。除了神经缺陷,患者被发现血压和脉搏升高。患者被迅速转移到三级护理诊所。通过测试排除各种差异,患者被诊断为非典型格林-巴利综合征并接受治疗.启动靶向治疗以预防自主神经失调相关的发病率。在管理层之后,病人的病情大大改善,他被允许康复,使他恢复到最佳健康状态。这项研究强调了迅速识别格林-巴利综合征的非典型表现的重要性,这可能有助于避免可预防的发病率和死亡率。
    This study examines a four-year-and-one-month-old male with no significant past medical, family, or surgical history who initially presented to the pediatric clinic with cough, rhinorrhea, conjunctivitis, emesis, leg and arm pain, and increased difficulty ambulating. The patient was transferred to the emergency department and tested positive for a non-COVID-19 coronavirus infection. The patient was stabilized, given intravenous fluids, and discharged only to return to the clinic the next day with the onset of a headache, right eye ptosis, an inability to bear weight, and bilateral upper and lower extremity weakness resulting in an ataxic gait. In addition to the neurological deficits, the patient was found to have an elevated blood pressure and pulse. The patient was promptly transferred to a tertiary care clinic. Through exclusion of various differentials via testing, the patient was diagnosed and managed for atypical Guillain-Barré syndrome. Targeted therapies were initiated to prevent dysautonomia-associated morbidity. Following management, the patient\'s condition vastly improved and he was admitted to rehabilitation bringing him back to optimal health. This study underlines the importance of prompt identification of atypical presentations of Guillain-Barré syndrome which may aid in avoiding preventable morbidity and mortality.
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  • 文章类型: Case Reports
    对小儿气道的轻微损害可能具有毁灭性的结果。不幸的是,梗阻的体征和症状可能不会立即出现,需要一段时间才能发展。因此,对于有烫伤液摄入史的儿童,医师应该有更高的怀疑气道阻塞指数。感染性和非感染性会厌的体征和症状确实重叠,区分的关键是通过仔细的病史和体检,尤其是在非语言儿童中。继发性细菌感染可能会使热会厌复杂化,并使图片有点混乱。因此,从一开始就表明通过多学科小组采取协调一致的方法,这些病例应得到管理并转介给更高的中心。
    A minor insult to the pediatric airway can have a devastating result. Unfortunately, the signs and symptoms of obstruction might not be present immediately and take some time to develop. Therefore, physicians should have a higher index of suspicion for airway obstruction in children that present with a history of ingestion of scalding liquid. Signs and symptoms of infectious vs noninfectious epiglottis do overlap and the key to differentiate is by careful history and physical exam, especially in nonverbal children. A secondary bacterial infection might complicate thermal epiglottis and make the picture a bit confusing. Therefore, a coordinated approach through a multidisciplinary team is indicated from the start and these cases should be managed and referred to a higher center.
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  • 文章类型: Case Reports
    异物吸入是严重的医疗紧急情况,是与意外伤害有关的死亡的第五大原因。该病例涉及一名23个月大的婴儿,他抽吸了两个乳胶气球,并在气球抽出过程中发生了心脏骤停。他复活了,但CT扫描显示缺氧性脑病.
    Foreign body aspiration is a serious medical emergency and the fifth leading cause of accidental injury-related fatalities. This case involves a 23-month-old infant who aspirated two latex balloons and developed cardiac arrest during balloon extraction. He was revived, but a CT scan revealed hypoxic encephalopathy.
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  • 文章类型: Case Reports
    脑静脉窦血栓形成(CVST)是继发于血凝块形成的大脑脑静脉阻塞。这些会导致颅内压升高,脑水肿,甚至可能有致命的后果,如中风。尽管CVST被认为是一种罕见的病理,据说这些在儿科人群中的发病率增加。这些患有CVST的人通常无症状,导致医生经常忽视并延迟可能的挽救生命的干预措施。目前的文献缺乏关于儿科人群“老年”范围内CVST的例子,特别是青少年。在这里,我们介绍了一名13岁女性因从高尔夫球车上摔下来而遭受创伤的案例,发现有实质内和蛛网膜下腔出血伴横窦血栓形成。
    Cerebral venous sinus thrombosis (CVST) is the occlusion of cerebral veins of the brain secondary to blood clot formation. These can result in increased intracranial pressure, cerebral edema, and may even have fatal consequences such as a stroke. Despite CVSTs being considered a rare pathology, these are said to have an increased incidence in the pediatric population. These individuals with CVST are often asymptomatic causing physicians to often overlook and delay possibly life-saving interventions. The current literature is lacking on CVST examples in the \"older\" range of the pediatric population, specifically teenagers. Here we present the case of a 13-year-old female with trauma secondary to a fall from a golf cart, who was found to have intraparenchymal and subarachnoid hemorrhages with transverse sinus thrombosis.
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  • 文章类型: Case Reports
    着色性干皮病(XP)是一种罕见的常染色体隐性遗传病理,影响核苷酸切除对紫外线辐射的修复。这导致发展眼科的倾向增加,神经学,以及细胞更新增加的皮肤状况。该病例报道了一名8岁印度男性的XP晚期表现,伴有转移性鳞状细胞癌(SCC)和感染性休克。静脉输液和广谱抗生素的应急管理并未显示出生命体征的改善。紧急的手术清创和肿瘤切除未能提高实验室价值。术后白细胞增多伴发热,需要将患者转移到超级专业肿瘤科。这种不良表现常见于XP相关的浸润性鳞状细胞癌。预防性管理需要早期识别和涉及皮肤科医生的多学科方法,眼科医生,还有外科医生.晚期表现围绕着通过严格的清创和化疗以及定期监测来控制疾病过程,因为即使在切除和化疗后,病变也会复发。
    Xeroderma pigmentosum (XP) is a rare autosomal recessive pathology affecting nucleotide excision repair against ultraviolet radiation. This leads to an increased predisposition to developing ophthalmological, neurological, and cutaneous conditions with an increased cell turnover. This case reports a late presentation of XP presenting with metastatic squamous cell carcinoma (SCC) and septic shock in an eight-year-old Indian male. Emergency management with IV fluid boluses and broad-spectrum antibiotics showed no improvement in vitals. Urgent surgical debridement and tumor debulking failed to improve laboratory values. Postoperative leukocytosis with fever spikes warranted the need to transfer the patient to a super-specialty oncology unit. Such an adverse presentation is commonly seen in XP-related invasive squamous cell carcinoma. Preventive management requires early identification and a multidisciplinary approach involving dermatologists, ophthalmologists, and surgeons. Late presentations revolve around control of the disease process by sharp debridement and chemotherapy with regular surveillance as the lesions tend to reoccur even after excision and chemotherapy.
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