نبذة مختصرة : Acute abdominal pain is one of the most frequent reasons for consultation in emergency departments. Its causes are diverse and are divided into surgical and medical. Surgical causes may be traumatic, obstructive or inflammatory. The last category includes perforated hollow viscus as a complication of duodenal ulcer, a rare condition in pediatrics.This paper presents the case of a previously healthy 14-year-old adolescent who attended the emergency department due to the sudden onset and rapid progression of abdominal pain in the right hypochondrium, which radiated to the lower back on the same side. This condition was associated with vasovagal symptoms and was initially managed as urolithiasis, considering clinical deterioration and obvious signs of generalized peritonitis, which required a diagnostic laparoscopy followed by laparotomy by pediatric surgery.Perforated duodenal ulcer was diagnosed during the procedure as the cause of the symptoms. This paper intends to show the experience of clinical cases with an initial diagnostic error and include complicated duodenal ulcer as a differential diagnosis. ; El dolor abdominal agudo es uno de los principales motivos de consulta en los servicios de urgencias, sus causas son diversas y se dividen en quirúrgicas y médicas. En este artículo se hace mención a las causas quirúrgicas que pueden ser de tipo traumático, obstructivo o inflamatorio. En esta última categoría se encuentra la perforación de víscera hueca como complicación de ulcera duodenal, entidad poco frecuente en la edad pediátrica.Se presenta el caso de un adolescente de 14 años, previamente sano, quien consultó a urgencias de medicina general por dolor abdominal de inicio súbito y de rápido progreso en hipocondrio derecho, con irradiación a zona lumbar del mismo lado, asociado a síntomas vaso vágales. Se da manejo primario como urolitiasis.Ante el deterioro clínico y los signos evidentes de peritonitis generalizada, el paciente es llevado a laparoscopia diagnóstica que requiere conversión a laparotomía por ...
Relation: https://revistas.unal.edu.co/index.php/revfacmed/article/view/59798/66674; https://revistas.unal.edu.co/index.php/revfacmed/article/view/59798/67403; https://revistas.unal.edu.co/index.php/revfacmed/article/view/59798/67508; Morrow S, Newman K. Current management of appendicitis. Semin. Pediatr. Surg. 2007;16(1):34-40. http://doi.org/bcbjrt.; Tamayo-Meneses L, Castillo-Loayza J. Dolor abdominal agudo, síntoma indirecto de neumonía: a propósito de tres casos. Cuad. Hosp. Clín. 2006 [cited 2016 Oct 19];51(1):65-70. Available from: https://goo.gl/FY43vC.; Árdela E, Domínguez F, Ansó S, Arce J. Dolor abdominal en la edad escolar: Avances. Bol. Pediatría. 2000;40(173):147-157.; Lin WC, Lin CH. Multidetector computed tomography in the evaluation of pediatric acute abdominal pain in the emergency department. Biomedicine (Taipei). 2016;6(2):10. http://doi.org/cfpz.; Nakayama DK. Examination of the Acute Abdomen in Children. J. Surg. Educ. 2016;73(3):548-52. http://doi.org/f8k3qx.; Coca-Robinot D, Liébana de Rojas C, Aguirre-Pascual E. Abdominal emergencies in pediatrics. Radiologia. 2016;58(Suppl 2):80-91. http://doi.org/cfp2.; García-Aparicio J. Abdomen agudo en el niño. Protocolos diagnóstico-terapéuticos de Urgencias Pediátricas SEUP-AEP. Madrid: Hospital Infantil Universitario La Paz. Available from: https://goo.gl/5ZMQhB.; Holguín D, Bautista, F, Fierro F, Holguín D, Rojas A. Prevalencia del dolor abdominal agudo y sus manifestaciones en el paciente pediátrico. Pediatría. 2011;44(1).; Reust CE, Williams A. Acute Abdominal Pain in Children. Am. Fam. Physician. 2016;93(10):830-6.; Gomes de Souza P, Ferreira AL. Acute abdominal pain as a manifestation of physical violence in an infant: alert to pediatricians. Rev. Paul. Pediatr. 2012;30(4):608-12. http://doi.org/cjxh.; Mazzi E. Dolor abdominal en niños. Rev. Soc. Bol. Ped. 2013 [cited 2016 Oct 19];52(1):50-7. Available from: https://goo.gl/RRT6QM.; Uribe-Garay C. Enfermedad ácido-péptica. CCAP. 2014 [cited 2018 Jan 29];13(3):37–48. Available from: https://goo.gl/wkVogA.; Malaty HM. Epidemiology of Helicobacter pylori. Best. Pract. Res. Clin. Gastroenterol. 2007;21:205-14. http://doi.org/bb7xdt.; Suebaum S, Michetti P. Helicobacter pylori infection. N. Engl. J. Med. 2002;347:1175-86. http://doi.org/dq2t6t.; Hua MC, Kong MS, Lai MW, Luo CC. Perforated peptic ulcer in children: a 20-year experience. J. Pediatr. Gastroenterol. Nutr. 2007;45(1):71-4. http://doi.org/fq84jj.; Amouei A, Ehsani F, Zarch MB, Tabatabaei SM, Ghodratipour Z. Peritonitis Following Duodenal Ulcer Perforation in a Newborn: A Case Report. J. Clin. Diagn. Res. 2016;10(11):PD10-PD11. http://doi.org/cfp3.; Trujillo M, García R, Sagaró E, Fragoso T, Lazo O, Borbolla E, et al. Úlcera gastroduodenal en pediatría. Rev. Gastroenterol. Perú. 1997;17(2).; Yildiz T, Ilce HT, Ceran C, Ilce Z. Simple patch closure for perforated peptic ulcer in children followed by Helicobacter pylori eradication. Pak. J. Med. Sci. 2014;30(3):493-496. http://doi.org/cfp4.; Yadav SK, Gupta V, El Kohly A, Al Fadhli W. Perforated duodenal ulcer: A rare complication of deferasirox in children. Indian. J. Pharmacol. 2013;45(3):293. http://doi.org/cfp5.; https://revistas.unal.edu.co/index.php/revfacmed/article/view/59798
Processing Request
No Comments.