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患儿男,3(7/(12))岁。2(8/(12))岁时因咳嗽5天、呕吐4天入院。呕吐频繁,每日约20—30次,以进食后明显,无胆汁及血性胃内容物,非喷射性,无发热。体检:精神萎糜,右下肺可闻及干、湿性罗音,腹软,左上腹及脐周轻压痛。查尿酮体阳性,腹部透视提示中上腹部分肠腔积气,无气液平面及两隔下游离气体。7天后呕吐顿停,元任何不适,食欲亢进。此后,类似发作12次,呕吐物初为胃内容物,后为胆汁、血丝及咖啡样物,伴有低热。每次均有过食、感冒、过度兴奋成疲劳诱因;且均于下半夜或清晨突然发作。发作时尿酮体阳性;脑电图除第二次为轻度异常(基本波率波型欠整,调节欠佳)外,其他3次均正常;电解质:Na~+、K~+降低;胃肠钡透;胃窦部粘膜变粗、张力高、痉挛。提示胃窦部炎症。胃内窥镜检
Male children, 3 (7 / (12)) years old. 2 (8 / (12)) aged 5 days due to cough, vomiting 4 days admitted. Frequent vomiting, about 20-30 times daily, after eating obvious, no bile and bloody stomach content, non-jet, no fever. Physical examination: spiritual wilt Mi, the lower right lung can smell and dry, wet rales, abdominal soft, left upper quadrant and umbilical tenderness. Urine ketone body check positive, abdominal fluoroscopy prompted mid-to-part of the intestine gas, no gas-liquid level and the two separated from the free gas. 7 days after vomiting stop, any discomfort, appetite hyperthyroidism. Since then, a similar episode of 12 times, vomit initially stomach content, followed by bile, bloodshot and coffee-like samples, accompanied by fever. Every time there is food, cold, over-excitement into a fatigue incentive; and both in the middle of the night or early morning sudden attack. Urine and ketone bodies were positive at the onset of attack; EEG was normal except for the second time in mild abnormality (basic wave pattern incompleteness and poor regulation); electrolyte: Na ~ + and K ~ + decreased; gastrointestinal Barium; gastric mucosa thicker, high tension, spasm. Prompt sinus inflammation. Gastric endoscopy