NEJM:胃里的蛔虫-病例报道

2020-11-26 MedSci原创 MedSci原创

患者为一名20岁男子,因腹痛、腹泻和呕吐1天而到急诊就诊,检查粪便发现蛔虫虫卵。

患者为一名20岁男子,因腹痛、腹泻和呕吐1天而到急诊就诊。他既往很健康,没有相关的病史。

心率每分钟96次,血压是96/60mmHg。经检查,腹部柔软而无压痛。实验室检查发现血红蛋白水平为19.5μg/dl(参考范围12至15),白细胞计数为20800/m3(参考范围为4000至11000),嗜中性粒细胞为72.7%,嗜酸性粒细胞计数为25/m3(参考范围20到500)。

对下腔静脉进行即时超声检查以评估患者的血管内液体状态。在检查期间,在胃腔内部看到了一个以卷曲运动的管状回声结构(如图A所示)。检查粪便中寄生虫和虫卵,发现蛔虫虫卵(如图B所示),并诊断为蛔虫病。

该患者除了接受静脉输液外,还服用了400mg单剂量的阿苯达唑,住院1天后即出院。出院后两周在门诊进行随访,他报告感觉良好,并指出他已经在大便中排出了蛔虫。

原始出处:

Vivek Chaurasia,et al.Ascaris in the Stomach.N Engl J Med.2020;https://www.nejm.org/doi/full/10.1056/NEJMicm2007312

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1179404, encodeId=45a711e94044c, content=好文章,原来蛔虫还能在胃里发育成长, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Fri Dec 31 19:16:31 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956652, encodeId=f34995665291, content=腹部B超可作为腹痛的常规检查方式。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LMxuvQxWQTTq6icl1IdHUTa99B8HLWs71jxRRyJE8la9yIHkMN5MdJlezl0ic7590PYksUYOOy4MrqkfOia5E5O2A/132, createdBy=e1552482838, createdName=es_Y, createdTime=Tue Apr 13 18:15:21 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904566, encodeId=5c1c904566de, content=惊悚, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201027/a6f0a005a1404edbb49a39617c69747d/ea09b8c227f54bf59bcde0492637fb45.jpg, createdBy=26305165930, createdName=146c7d60m05暂无昵称, createdTime=Thu Dec 03 13:02:49 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290061, encodeId=749412900619e, content=<a href='/topic/show?id=af9f88e7946' target=_blank style='color:#2F92EE;'>#蛔虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88779, encryptionId=af9f88e7946, topicName=蛔虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Nov 28 00:01:27 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035507, encodeId=508c103550ebf, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 12:01:27 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902445, encodeId=5fc0902445b2, content=<a href='/topic/show?id=d05e65e291f' target=_blank style='color:#2F92EE;'>#消化#</a> <a href='/topic/show?id=b6ade07681f' target=_blank style='color:#2F92EE;'>#病例#</a> 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65729, encryptionId=d05e65e291f, topicName=消化), TopicDto(id=70768, encryptionId=b6ade07681f, topicName=病例)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Thu Nov 26 11:44:36 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2021-12-31 屋顶瞄爱赏月

    好文章,原来蛔虫还能在胃里发育成长

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1179404, encodeId=45a711e94044c, content=好文章,原来蛔虫还能在胃里发育成长, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Fri Dec 31 19:16:31 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956652, encodeId=f34995665291, content=腹部B超可作为腹痛的常规检查方式。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LMxuvQxWQTTq6icl1IdHUTa99B8HLWs71jxRRyJE8la9yIHkMN5MdJlezl0ic7590PYksUYOOy4MrqkfOia5E5O2A/132, createdBy=e1552482838, createdName=es_Y, createdTime=Tue Apr 13 18:15:21 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904566, encodeId=5c1c904566de, content=惊悚, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201027/a6f0a005a1404edbb49a39617c69747d/ea09b8c227f54bf59bcde0492637fb45.jpg, createdBy=26305165930, createdName=146c7d60m05暂无昵称, createdTime=Thu Dec 03 13:02:49 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290061, encodeId=749412900619e, content=<a href='/topic/show?id=af9f88e7946' target=_blank style='color:#2F92EE;'>#蛔虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88779, encryptionId=af9f88e7946, topicName=蛔虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Nov 28 00:01:27 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035507, encodeId=508c103550ebf, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 12:01:27 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902445, encodeId=5fc0902445b2, content=<a href='/topic/show?id=d05e65e291f' target=_blank style='color:#2F92EE;'>#消化#</a> <a href='/topic/show?id=b6ade07681f' target=_blank style='color:#2F92EE;'>#病例#</a> 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65729, encryptionId=d05e65e291f, topicName=消化), TopicDto(id=70768, encryptionId=b6ade07681f, topicName=病例)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Thu Nov 26 11:44:36 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2021-04-13 es_Y

    腹部B超可作为腹痛的常规检查方式。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1179404, encodeId=45a711e94044c, content=好文章,原来蛔虫还能在胃里发育成长, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Fri Dec 31 19:16:31 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956652, encodeId=f34995665291, content=腹部B超可作为腹痛的常规检查方式。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LMxuvQxWQTTq6icl1IdHUTa99B8HLWs71jxRRyJE8la9yIHkMN5MdJlezl0ic7590PYksUYOOy4MrqkfOia5E5O2A/132, createdBy=e1552482838, createdName=es_Y, createdTime=Tue Apr 13 18:15:21 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904566, encodeId=5c1c904566de, content=惊悚, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201027/a6f0a005a1404edbb49a39617c69747d/ea09b8c227f54bf59bcde0492637fb45.jpg, createdBy=26305165930, createdName=146c7d60m05暂无昵称, createdTime=Thu Dec 03 13:02:49 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290061, encodeId=749412900619e, content=<a href='/topic/show?id=af9f88e7946' target=_blank style='color:#2F92EE;'>#蛔虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88779, encryptionId=af9f88e7946, topicName=蛔虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Nov 28 00:01:27 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035507, encodeId=508c103550ebf, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 12:01:27 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902445, encodeId=5fc0902445b2, content=<a href='/topic/show?id=d05e65e291f' target=_blank style='color:#2F92EE;'>#消化#</a> <a href='/topic/show?id=b6ade07681f' target=_blank style='color:#2F92EE;'>#病例#</a> 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65729, encryptionId=d05e65e291f, topicName=消化), TopicDto(id=70768, encryptionId=b6ade07681f, topicName=病例)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Thu Nov 26 11:44:36 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2020-12-03 146c7d60m05暂无昵称

    惊悚

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1179404, encodeId=45a711e94044c, content=好文章,原来蛔虫还能在胃里发育成长, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Fri Dec 31 19:16:31 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956652, encodeId=f34995665291, content=腹部B超可作为腹痛的常规检查方式。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LMxuvQxWQTTq6icl1IdHUTa99B8HLWs71jxRRyJE8la9yIHkMN5MdJlezl0ic7590PYksUYOOy4MrqkfOia5E5O2A/132, createdBy=e1552482838, createdName=es_Y, createdTime=Tue Apr 13 18:15:21 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904566, encodeId=5c1c904566de, content=惊悚, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201027/a6f0a005a1404edbb49a39617c69747d/ea09b8c227f54bf59bcde0492637fb45.jpg, createdBy=26305165930, createdName=146c7d60m05暂无昵称, createdTime=Thu Dec 03 13:02:49 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290061, encodeId=749412900619e, content=<a href='/topic/show?id=af9f88e7946' target=_blank style='color:#2F92EE;'>#蛔虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88779, encryptionId=af9f88e7946, topicName=蛔虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Nov 28 00:01:27 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035507, encodeId=508c103550ebf, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 12:01:27 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902445, encodeId=5fc0902445b2, content=<a href='/topic/show?id=d05e65e291f' target=_blank style='color:#2F92EE;'>#消化#</a> <a href='/topic/show?id=b6ade07681f' target=_blank style='color:#2F92EE;'>#病例#</a> 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65729, encryptionId=d05e65e291f, topicName=消化), TopicDto(id=70768, encryptionId=b6ade07681f, topicName=病例)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Thu Nov 26 11:44:36 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1179404, encodeId=45a711e94044c, content=好文章,原来蛔虫还能在胃里发育成长, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211111/81c0b64745c644319545ec26d7ef0b34/9ddb2864d5df4dd9bf4305e380bffc96.jpg, createdBy=c7835705079, createdName=屋顶瞄爱赏月, createdTime=Fri Dec 31 19:16:31 CST 2021, time=2021-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956652, encodeId=f34995665291, content=腹部B超可作为腹痛的常规检查方式。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/LMxuvQxWQTTq6icl1IdHUTa99B8HLWs71jxRRyJE8la9yIHkMN5MdJlezl0ic7590PYksUYOOy4MrqkfOia5E5O2A/132, createdBy=e1552482838, createdName=es_Y, createdTime=Tue Apr 13 18:15:21 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904566, encodeId=5c1c904566de, content=惊悚, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201027/a6f0a005a1404edbb49a39617c69747d/ea09b8c227f54bf59bcde0492637fb45.jpg, createdBy=26305165930, createdName=146c7d60m05暂无昵称, createdTime=Thu Dec 03 13:02:49 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290061, encodeId=749412900619e, content=<a href='/topic/show?id=af9f88e7946' target=_blank style='color:#2F92EE;'>#蛔虫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88779, encryptionId=af9f88e7946, topicName=蛔虫)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Nov 28 00:01:27 CST 2020, time=2020-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035507, encodeId=508c103550ebf, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Nov 26 12:01:27 CST 2020, time=2020-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=902445, encodeId=5fc0902445b2, content=<a href='/topic/show?id=d05e65e291f' target=_blank style='color:#2F92EE;'>#消化#</a> <a href='/topic/show?id=b6ade07681f' target=_blank style='color:#2F92EE;'>#病例#</a> 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。, beContent=null, objectType=article, channel=null, level=null, likeNumber=202, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65729, encryptionId=d05e65e291f, topicName=消化), TopicDto(id=70768, encryptionId=b6ade07681f, topicName=病例)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200814/a16c22989a2247c0a54b44d3e3acdaaa/44abb281938b4e04bc086f8345254626.jpg, createdBy=fb825296401, createdName=BJying, createdTime=Thu Nov 26 11:44:36 CST 2020, time=2020-11-26, status=1, ipAttribution=)]
    2020-11-26 旺医

    顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息

    0

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    2020-11-26 BJying

    #消化# #病例# 这例蛔虫病病例为消化道疾病研究提供了比较好的例子。

    0

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