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患男,5岁,因反复间断腹痛2年,进行性消瘦3月入院。病初患儿出现以脐周为主的阵发性腹痛,持续时间不定,可自行缓解,3月前腹痛加重,伴进行性消瘦。病后精神渐差,食欲明显减退。无黑便史。智力与同龄儿相当。查体:营养差,精神欠佳,头发黄而干燥;腹部柔软、呈舟状,有时可见肠型及蠕动波,脐周轻度压痛,无包块,肠鸣音活跃。心、肺、肝、脾未见异常。全消化道X线钡餐检查示十二指肠球部梗阻,球部充盈过大,向胃窦部返流,钡剂通过十二指肠以下呈线状,口服胃复安7h后钡剂到达回盲部,各段小肠及回盲部未见异常。纤维胃镜显示幽门呈
Male, 5 years old, because of repeated abdominal pain for 2 years, progressive weight loss March admission. Early onset of disease in patients with umbilical cord-based paroxysmal abdominal pain, duration of indefinite, self-remission, abdominal pain increased in March, with progressive weight loss. Psychosis after the illness, appetite decreased significantly. No black history. Intelligence is equal to that of your peers. Physical examination: poor nutrition, poor health, hair yellow and dry; abdomen soft, was boat-shaped, and sometimes intestinal type and peristaltic waves, mild tenderness around the umbilical cord, no mass, bowel sounds active. Heart, lung, liver, spleen no abnormalities. Gastrointestinal digestive tract barium meal examination showed duodenal obstruction, filling the ball too large, reflux to the antrum, barium through the duodenal following was linear, oral metoclopramide 7h barium arrived Ileocecal, all segments of the small intestine and ileocecal no abnormalities. Fiber gastroscopy showed pylorus presented