Children's lower limbs curled up

Introduction Children with lower extremity distortion: the main manifestation of intestinal fistula is persistent, difficult to appease crying. The main manifestations are crying and uneasiness, which may be accompanied by vomiting, cheek flushing, tumbling, and distortion of both lower extremities. Intestinal fistula, also known as spastic colic, is the most common functional abdominal pain in children with acute abdominal pain. The clinical manifestations are usually healthy children. If sudden and intermittent abdominal pain occurs suddenly, and abnormal signs are not found during the interval, it is the main feature of the disease. The abdominal pain of a child can last for a few minutes or tens of minutes, and it is time to stop.

Cause

First, the gastrointestinal factors.

(1) Excessive gas production in the intestine: There are four major sources of intestinal gas: the swallowed gas; the neutralization of gastric acid production; the diffusion from the blood and the fermentation of bacteria.

(2) Increased intestinal motility.

(three) gastrointestinal hormones.

(4) Dietary factors: Some studies have shown that intestinal fistula in breast-fed infants is related to the mother's drinking milk, and food allergies may be a cause of intestinal fistula.

(5) Other factors.

Second, non-gastrointestinal factors.

an examination

Related inspection

Detection of trace elements in human musculoskeletal system

Routine inspection:

1. Blood routine:

Blood routine is the most common and basic blood test. Blood consists of two major parts, fluid and tangible cells, which are routinely tested for blood. Blood has three different functions of cells - red blood cells (commonly known as red blood cells), white blood cells (commonly known as white blood cells), and platelets. The disease is judged by observing the quantitative change and the morphological distribution. It is one of the commonly used auxiliary examination methods for doctors to diagnose the disease.

2. It will be regular.

3. Biochemical items.

4. Abdominal penetration.

Differential diagnosis

(1) Diseases that often need to be identified

1, intussusception:

It is a disease that should be identified first in infants and young children. It is a fat male infant who occurs in 4 to 10 months. It can occur in the whole year and peak in spring. Typical clinical manifestations include paroxysmal crying, vomiting, abdominal sausage-like masses, and jam-like (blood) stools. Paroxysmal crying is caused by the intussusception of the intussusception, which is often more severe and regular than the simple intestinal fistula. Vomiting occurs almost in every intussusception, and simple intestinal fistula is less common. Most children have access to abdominal sausage-like masses, usually located along the colonic frame, half of which are located in the right upper abdomen. The mass is larger than the intestine that is touched by the intestinal tract, and has some elasticity and tenderness. Jams may be discharged after more than 6 hours of onset. Gas or barium enema can confirm clinical diagnosis (except rare intussusception) and can be used to try intussusception by increasing the pressure of the intestine.

2, acute appendicitis:

Acute suppurative appendicitis occurs mostly in children over 5 years of age, but it is not impossible in infants and young children. The typical symptom of appendicitis is metastatic right lower abdominal pain. In the early stage of the disease, the child often reports self-abdominal or upper abdominal pain, and some can not determine the abdominal pain. At this time, it can be confused with intestinal fistula. After a few hours, the abdominal pain is mostly fixed in the right lower abdomen. Abdominal pain is generally persistent, but appendicitis with obstructive properties such as fecal stone obstruction and parasites in the appendix can be mainly paroxysmal and spastic pain for a period of time, and should also be differentiated from intestinal fistula. The main point of identification is that all types of appendicitis must have fixed tenderness in the right lower abdomen. The disease may be slightly longer and may have muscle tension, which is different from intestinal fistula. Sometimes it takes several checks to determine if the tender point is fixed. In addition, appendicitis is often accompanied by early nausea, vomiting, and later fever and increased white blood cells.

3. Acute gastroenteritis or intestinal infection:

It can occur in children of all ages. In addition to paroxysmal abdominal pain, symptoms such as vomiting, diarrhea and fever may occur, and dehydration may occur due to vomiting and diarrhea. All of the above are not typical manifestations of intestinal fistula, but the initial stage of the disease still needs to be differentiated from intestinal fistula. Intestinal infections, including bacterial dysentery and amoebic dysentery, should be diagnosed in conjunction with laboratory tests of stool.

4, mesenteric lymphadenitis:

Children are more common and generally have a history of upper respiratory tract infections. The child often reports self-reported faint abdominal pain, which is paroxysmal. Sometimes it is not possible to determine the location of abdominal pain, and often the right lower quadrant pain, because the mesenteric membrane is rich in lymphoid tissue. Physical examination may have tenderness in the right lower quadrant, but the tender point is not fixed, nor is it accompanied by muscle tension. Do not forget to check the throat and lungs of the child for suspected mesenteric lymphadenitis.

5. Intestinal ascariasis and biliary mites:

Abdominal pain caused by intestinal ascariasis is actually a bowel pain, and it is paroxysmal, sometimes vomiting and abdominal tenderness, it is difficult to touch the mites. Although the disease is similar to the clinical manifestations of intestinal fistula, it is also determined to be identified because of different treatment methods. The typical clinical manifestation of biliary mites is severe paroxysmal abdominal pain. The upper right side of the upper abdomen is the most important pain, which may be accompanied by local tenderness and muscle tension. Biliary locusts are sometimes associated with intestinal ascariasis and should be noted. The locust complication is related to the national health conditions and living habits, so the diagnosis must be combined with medical history. Although the disease has decreased in recent years, it is still a common disease in rural areas with poor sanitation.

6, constipation:

Chronic constipation generally does not cause abdominal pain, but constipation caused by temporary causes can often induce sigmoid colon fistula and paroxysmal abdominal pain. This disease occurs mostly in children. Abdominal pain is often in the lower abdomen or to the left, sometimes touching the gut tube or / and dry hard stool blocks. Abdominal pain can often be relieved or disappeared after enema with Kaisailu or soapy water. In addition, infants and even newborns sometimes cry before defecation, crying after defecation, whether the bowel spasm is caused by local stimulation of the stool or nerve reflexes.

(2) Other diseases that need to be identified

Surgical: intestinal torsion of the sacral kidney and ureteral calculi, superior mesenteric artery compression syndrome.

Internal medicine: biliary tract abdominal type, allergic purpura abdominal type, epilepsy porphyria and other related diseases should even notice abdominal pain caused by lobar pneumonia and pericarditis.

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