自然分娩诱发浮肋综合征一例误诊报告及文献回顾

Misdiagnosed Floating Rib Syndrome Caused by Natural Delivery(a Case Report and Literature Review)

目的分析浮肋综合征临床特点及误诊原因,总结经验教训,提高临床对浮肋综合征的认识。方法对我院近期收治的1例长期误诊的于自然分娩后诱发的浮肋综合征的临床资料进行回顾性分析,并结合国内外文献进行复习,总结本病的发病机制、临床特点及诊断治疗。结果本例为42岁外籍女患者,因间断性左上腹疼痛4年到我院就诊。曾多次在外院行胃镜、腹部B超、CT、MRI及心电图等检查,仅胃镜检查提示浅表性胃炎,余均未见明显异常。予口服奥美拉唑、解郁丸等药物治疗效果欠佳。入我院后经钩形手法检查示阳性,且结合患者腹痛等临床表现确诊为浮肋综合征,采用特定电磁波治疗仪(TDP)治疗,配合口服布洛芬,1周后症状缓解。结论临床医生在接诊腹痛患者时应全面详细了解病史,考虑到浮肋综合征的可能,及时行钩形手法检查,及早诊断并治疗。

Objective To improve the understanding of floating rib syndrome by analyzing its clinical features and the causes of misdiagnosis,and summing up experience and lessons from the past. Methods The clinical data of one case of misdiagnosed and mistreated floating rib syndrome caused by natural delivery admitted to our hospital was retrospectively analyzed,and literature review was studied. The pathogenesis,clinical features,diagnosis and treatment of floating rib syndrome were summarized. Results This patient was a 42-year-old American woman who was admitted to our hospital for intermittent left upper quadrant abdominal pain for 4 years. She underwent gastroendoscopic,abdominal ultrasound examination,CT scan,MRI and ECG before admission. All work-up did not show any positive findings except for superficial gastritis reported by endoscopy. She ever took Omeprazole and Joey pills,but her symptoms were not alleviated. After her admission to our hospital,the patient was diagnosed as having floating rib syndrome because her abdominal pain could be reproduced on hooking maneuver. Her symptoms were alleviated after one week of TDP and oral Ibuprofen therapy. Conclusion Physicians should collect comprehensive medical history and evaluate the possibility of floating rib syndrome with hooking maneuver for any patients with abdominal pains in order to make correct diagnosis and apply appropriate treatment in time.