The 11 -year -old girl almost lost the ovaries on both sides, and the parents were negligent more than once ...

For medical professionals for reading reference

Adolescent abdominal pain, don't ignore the acute abdomen of gynecology

Recently, experts from many departments such as gynecology, pediatrics, and internal medicine in the hospital where the author is surrounded by the bed of a small patient.

After a meal, the child's abdominal pain is more than

Pediatrics discover the clue

Xiaoxue (a pseudonym) is 11 years old. The menstrual period is still in the future. He is only 130cm tall, which is more than 10 cm compared with the standard of children of the same age.

The mother was very anxious and thought that she could have more exercise, so she reported to the child Latin dance class.

After Xiaoxue dancing, he often feels abdominal discomfort and has a feeling of pain and pain, but it can be relieved after rest. She thought it was tired and did not tell parents.

Some time ago, when the winter vacation, Xiaoxue ate ice cream after eating the big meal. She began to feel uncomfortable, faintly sore, nauseous, and could not be solved. Parents only thought she had broken her belly and didn't care too much.

At 3 o'clock in the morning, Xiaoxue's abdominal pain was even more obvious. The anus swelling worsened. Parents took the medicine for gastroenteritis for their children, and pasted the navel and warm the stomach to continue observing. At 6 o'clock in the morning, the child's abdominal pain was intensified and vomiting. The parents felt bad, and quickly sent the child to the hospital for treatment.

The emergency doctor first considered gastroenteritis, but there was no signs of blood checking. After doing gastrointestinal color Doppler ultrasound, no obvious abnormalities were seen. After prescribing the medicine to improve the gastrointestinal tract, it is recommended to transfer to the higher -level hospital for treatment.

Parents were nearly noon when they came to our hospital. After arriving at the hospital, the parents hung the pediatric emergency department. The pediatrics did not improve the symptoms after watching Xiaoxue. It will exacerbate and have no symptoms of diarrhea.

When asking the medical history again, the doctor found that the child removed the appendix due to "appendicitis" 6 years ago. Two years ago, the left attachment was removed due to "the left ovary reversing necrosis".

The body found that Xiaoxue's right lower abdomen tenderness and reflection pain were particularly obvious. The pediatric doctor suddenly felt that it was not such a simple thing to eat bad stomachs. Instead of except, there were intestinal obstruction, twisted, and the cause of gynecological acute abdomen. Therefore, he called the Department of Medicine, Surgery, and Gynecological Multi -Disciplines (MDT).

After opening the abdominal cavity

Only one side of the child's ovarian attachment is left

After an urgent discussion of MDT, considering the possibility of a child's attachment to reverse, immediately conduct gynecological color ultrasound examinations to exclude gynecological diseases and then conduct internal surgical disease -related examinations. The examination was carried out by the experienced gynecological ultrasound physician through the abdomen and rectal. not

Scan found that: the right ovary increased, 5.4cm*3.0cm*3.0cm, and the detection of multiple follicles, the next to the 2.4cm*1.0cm uneven quality echo, the border is still clear, it seems to be visible; pelvic accumulation The liquid is about 3.9cm*1.0cm. Results Tips: The right ovary reverses!

The diagnosis is basically clear. At this time, the child has been in pain for nearly 24 hours. Since the child has removed the attachment on one side, if the right attachment is necrotic, the consequences will be unimaginable ...

Can't delay for another minute! After fully communicating and talking with our family members, we immediately contacted the operating room, opened a green channel, and surgery for laparoscopy.

During the operation, I saw the right attachment twisted clockwise! The right ovarian increases, about 5cm*4cm*3.0cm. On the surface, multiple purple -blue spots can be seen on the surface, part of which are purple and black.

Figure 1: Turn on the right attachment

Figure 2: The left attachment is missing

Turning up so long, ovarian function is not affected.

Fortunately, after the ovarian and fallopian tube resumed normal anatomical positions, the surface color of the fallopian tube gradually rosy, and the purple and blue surface of the ovary surface became lighter than before. Finally relieved, the ovaries and fallopian tubes showed no signs of necrosis, which can be retained!

Nenes, not the first time ...

In communicating with parents, we learned that Xiaoxue's last attachment was also due to the negligence of parents: the child's abdominal pain for several days, not seriously, and then went to the hospital for diagnosis and treatment.

Fortunately, the pediatrician checked carefully and noticed the cause of abdominal pain.

However, it was too late to be diagnosed after several rounds of examination. In the end, Xiaoxue left attachment was completely necrotic and could not be retained. Parents later forgot to check the reason why Xiaoxue developed slowly.

This time, things are almost the same, but lucky is that the hospital quickly made a diagnosis and treatment plan through the MDT model to avoid the re -occurrence of tragedy. At the same time, according to the opinions of the pediatrician, the child was allowed to grow and develop outpatient clinics. The cause of the child's slow development -pituitary dysplasia and empty butterfly saddles.

Subsequently, pediatricians formulated the corresponding diagnosis and treatment plan for Xiaoxue. At the same time, parents should be told to restrict their children's violent activities after surgery, especially the movement of sudden changes in positions to avoid the occurrence of ovarian reversal again.

Gynecological abdomen

Don't ignore the teenagers

Gynecological abdomen is a group of gynecological urgency with abdominal pain as the main symptoms. During the consultation, most of the complaints of abdominal pain. Common gynecological acute abdomen include abnormal pregnancy, acute pelvic inflammatory disease, luteal rupture, and ovarian cysts to reverse.

Because gynecological acute abdomen is more common in adult women, and early symptoms are abdominal pain, nausea, vomiting, similar to eating bad stomach, parents sometimes ignore.

But in fact, it is not uncommon for teenagers to exercise, and the occurrence of ovarian cysts is not uncommon. Some hospitals have also been diagnosed with young girls to reverse ovarian cysts! Figure 3: News screenshot

Once the parents do not pay attention to, and the doctor ignores this possibility, it will not only delay the illness, but also affect the child's future life.

postscript

not

Xiaoxue has been discharged at present and has begun treatment for poor pituitary development. The author has thought that if parents can go to the hospital when they first notice that Xiaoxue's development is slow, and find out the cause, will it not happen later?

This is just a hypothesis. However, it is undeniable that as the classification of specialists and Asian colleges gradually refined, how important it is to perform MDT in time when encountering difficult cases -to minimize misdiagnosis and misunderstandings, and avoid referrals, repeated examinations, shorten patients with patients, shorten patients, and shorten patients with patients. The waiting time for diagnosis and treatment.

Through MDT, the selectivity of the treatment plan can also be added, the best diagnosis and treatment plan can be formulated, so that patients can get better diagnosis and treatment.

May our efforts get the health of patients!

Source: Obstetrics and Gynecology Channel in the medical community

Author: Guo Dongxia

Editor: Wang Hang

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