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患儿:男,5天,孕34周。剖宫产出生,产后2天因抽搐、气促、神倦、吮乳差由妇产科转入新生儿病房。查体:一般情况好,入院后第三天晚突然呼吸急促,反应差,哭声细小,皮肤中度黄染,双肺呼吸音粗,腹胀,肠鸣音消失,即行X线检查。 立卧位腹部平片显示:腹部出现大量游离气体,双膈明显抬高,推挤肝脾及肠管向中下移位,使腹腔内脏清楚地衬托出来,胃泡消失,肠内气体减少,无肠管扩张及气液平面。 手术所见:腹腔内大量气体逸出,腔内布满黄白色奶样残渣,肝胆脾及肠管无异常。胃底穿孔裂开约5cm×3cm,胃壁组织发育不全,薄如纸状。术后一天死亡。病理结果:胃壁肌层缺损。
Children: male, 5 days, 34 weeks pregnant. Cesarean section was born, 2 days postpartum due to convulsions, shortness of breath, Shen tired, sucking milk from obstetrics and gynecology into the neonatal ward. Physical examination: the general situation is good, the third day after admission sudden shortness of breath late, poor response, cries of small, moderately yellowish skin, lungs breath sounds thick, bloating, bowel sounds disappear, that line X-ray examination. Vertical abdominal plain film showed: a lot of free gas in the abdomen, double diaphragm was significantly elevated, pushing the liver and spleen and bowel shift to the next, so that the abdominal viscera clearly set off, disappearance of gastrulation, intestinal gas decreased, no Intestinal dilation and gas-liquid level. Surgical findings: a large number of gas escape intraperitoneal cavity filled with yellowish white milk-like residue, hepatobiliary spleen and intestinal no abnormalities. Perforation of the stomach perforation about 5cm × 3cm, gastric wall hypoplasia, thin as paper. One day after the operation. Pathological results: gastric wall muscle defect.