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慢性腹痛为小儿常见症状,与胃及十二指肠炎症及溃疡关系密切,但此种关系易为医者疏忽而致误诊。本文报告9年间经钡餐检查证实的252例,包括球部溃疡、慢性胃炎、胃窦炎、十二指肠炎、胃溃疡等,可合并两种以上病变。年龄1(1/2)～13岁,最突出的症状为腹痛,且多为慢性短阵性(6月～1年者占42.46%)、不定时(81.75%)疼痛。作为胃、十二指肠病特点的饭后及饥饿性疼痛反而少见。少数(3.57%)呈阵发性剧痛,其中4例曾多次误为胆道蛔虫病。疼痛部位上腹50%,脐周11.51%,中上腹痛7.54%,部位不定者30.95%。上腹压痛59.13%,除腹痛外,吐酸占37.30%,其他如呕吐、呃气、呕血、便血等均<10%,由于腹痛短阵发生、不典型和长期性易为家长及医者忽视,常反复误诊为肠蛔虫病、消化紊乱,肠系膜淋巴结炎、腹型癫痫等。同时合并肠蛔虫病者更易误诊。本文中一例于脑震荡后,两例于服解热止痛片后发生出血,值得注意。由于胃、十二指肠疾患在儿科并非罕见,且症状极不典型,建议对慢性腹痛病儿应加强钡餐检查以免漏误诊。
Chronic abdominal pain is a common symptom in children, and gastric and duodenal inflammation and ulcers are closely related, but this relationship is easily negligent due to misdiagnosis of the doctor. This article reports 252 cases confirmed by barium meal examination in 9 years, including ulcer, chronic gastritis, antral gastritis, duodenitis, gastric ulcer, which can be combined with two or more lesions. Age 1 (1/2) ~ 13 years old, the most prominent symptom was abdominal pain, and mostly chronic malaria (June to 1 year accounted for 42.46%), irregular (81.75%) pain. As a stomach, duodenal disease characteristics of hunger and hunger after the pain rare. A minority (3.57%) were paroxysmal pain, of which 4 cases have repeatedly mistaken for biliary ascariasis. Upper abdominal pain area 50%, 11.51% umbilical cord, abdominal pain in the middle of the 7.54%, undetermined position of 30.95%. In addition to abdominal pain, spit acid accounted for 37.30%, others such as vomiting, uh gas, hematemesis, blood in the stool were <10%, due to abdominal pain burst, atypical and long-term easy to ignore for parents and doctors, Often misdiagnosed as intestinal ascariasis, digestive disorders, mesenteric lymphadenitis, abdominal epilepsy and so on. Patients with concomitant intestinal ascariasis are also more likely to be misdiagnosed. In this article, one case after concussion, two cases of anti-fever after taking painkillers occurred bleeding, it is noteworthy. Due to the stomach, duodenal disease is not uncommon in pediatrics, and the symptoms are extremely atypical, it is recommended for children with chronic abdominal pain should enhance barium meal examination to avoid misdiagnosis.