Delayed diagnosis in a child with strangulated mesenteric hernia
Abstract Background Strangulated intestinal obstruction is a life‐threatening condition that should be considered as a differential diagnosis in children with shock. However, it has pitfalls in diagnosis and can lead to diagnostic errors. Case Presentation A 3‐month‐old male patient presented with a...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Acute Medicine & Surgery |
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| Online Access: | https://doi.org/10.1002/ams2.977 |
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| author | Kenichi Tetsuhara Kazunobu Nakabayashi Mamoru Muraoka Rie Kikuno Michiko Ueda Ryo Inoue Makoto Hayashida |
| author_facet | Kenichi Tetsuhara Kazunobu Nakabayashi Mamoru Muraoka Rie Kikuno Michiko Ueda Ryo Inoue Makoto Hayashida |
| author_sort | Kenichi Tetsuhara |
| collection | DOAJ |
| description | Abstract Background Strangulated intestinal obstruction is a life‐threatening condition that should be considered as a differential diagnosis in children with shock. However, it has pitfalls in diagnosis and can lead to diagnostic errors. Case Presentation A 3‐month‐old male patient presented with a pale complexion lasting 2 h and abnormal crying. He was in shock with lactic acidosis, altered mental status, and slight abdominal distension. He required volume resuscitation, vasoactive agents, and transfusion. On Day 2, he had marked abdominal distension and acute kidney injury, which required continuous kidney replacement therapy. Contrast‐enhanced computed tomography revealed extensive intestinal ischemia. It took 33.5 h from his arrival to the computed tomography, leading to operative management. The small intestine had entered a mesenteric hiatus, leading to ischemia. He was diagnosed with strangulated mesenteric hernia. Conclusion In this case, four pitfalls led to delayed diagnosis. Factors for diagnostic errors specific to strangulated intestinal obstruction and intensive care should be noted. |
| format | Article |
| id | doaj-art-0a5b4c52c33745a2bdc25ea89a7b00ec |
| institution | Kabale University |
| issn | 2052-8817 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acute Medicine & Surgery |
| spelling | doaj-art-0a5b4c52c33745a2bdc25ea89a7b00ec2024-12-30T10:18:37ZengWileyAcute Medicine & Surgery2052-88172024-01-01111n/an/a10.1002/ams2.977Delayed diagnosis in a child with strangulated mesenteric herniaKenichi Tetsuhara0Kazunobu Nakabayashi1Mamoru Muraoka2Rie Kikuno3Michiko Ueda4Ryo Inoue5Makoto Hayashida6Department of Critical Care Medicine Fukuoka Children's Hospital Fukuoka JapanDepartment of Pediatric Surgery Fukuoka Children's Hospital Fukuoka JapanDepartment of Critical Care Medicine Fukuoka Children's Hospital Fukuoka JapanDepartment of Critical Care Medicine Fukuoka Children's Hospital Fukuoka JapanDepartment of Pediatric Surgery Fukuoka Children's Hospital Fukuoka JapanDepartment of Critical Care Medicine Fukuoka Children's Hospital Fukuoka JapanDepartment of Pediatric Surgery Fukuoka Children's Hospital Fukuoka JapanAbstract Background Strangulated intestinal obstruction is a life‐threatening condition that should be considered as a differential diagnosis in children with shock. However, it has pitfalls in diagnosis and can lead to diagnostic errors. Case Presentation A 3‐month‐old male patient presented with a pale complexion lasting 2 h and abnormal crying. He was in shock with lactic acidosis, altered mental status, and slight abdominal distension. He required volume resuscitation, vasoactive agents, and transfusion. On Day 2, he had marked abdominal distension and acute kidney injury, which required continuous kidney replacement therapy. Contrast‐enhanced computed tomography revealed extensive intestinal ischemia. It took 33.5 h from his arrival to the computed tomography, leading to operative management. The small intestine had entered a mesenteric hiatus, leading to ischemia. He was diagnosed with strangulated mesenteric hernia. Conclusion In this case, four pitfalls led to delayed diagnosis. Factors for diagnostic errors specific to strangulated intestinal obstruction and intensive care should be noted.https://doi.org/10.1002/ams2.977childdelayed diagnosisdiagnostic errorsmesenteric herniastrangulated intestinal obstruction |
| spellingShingle | Kenichi Tetsuhara Kazunobu Nakabayashi Mamoru Muraoka Rie Kikuno Michiko Ueda Ryo Inoue Makoto Hayashida Delayed diagnosis in a child with strangulated mesenteric hernia Acute Medicine & Surgery child delayed diagnosis diagnostic errors mesenteric hernia strangulated intestinal obstruction |
| title | Delayed diagnosis in a child with strangulated mesenteric hernia |
| title_full | Delayed diagnosis in a child with strangulated mesenteric hernia |
| title_fullStr | Delayed diagnosis in a child with strangulated mesenteric hernia |
| title_full_unstemmed | Delayed diagnosis in a child with strangulated mesenteric hernia |
| title_short | Delayed diagnosis in a child with strangulated mesenteric hernia |
| title_sort | delayed diagnosis in a child with strangulated mesenteric hernia |
| topic | child delayed diagnosis diagnostic errors mesenteric hernia strangulated intestinal obstruction |
| url | https://doi.org/10.1002/ams2.977 |
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