医学英语在线翻译

Decompressive laparotomy has been shown to effec-
tively reduce IAP and reverse the symptoms typically
associated with ACS [32]. In patients with severe acute
pancreatitis and IAH, intra-abdominal fluid collections
may not always be present and therefore decompres-
sive laparotomy and temporary abdominal closure is
the most effective way of decreasing IAP [7, 15, 33].
The most common approach to decompressive
laparotomy is through a long, vertical midline incision,
but a transverse incision to anticipate later pancreatic
surgery may also be used. Because of the risk of

CASE 1: A Young Boy With Progressive Muscular and Pseudohypertrophy

of Calves
CLINICAL DATA
This 5-year-old boy was the product of a normal pregnancy and

delivery. He began to walk at the age of 15 months but has never be a

able to run. By the age of 3, he had difficulty climbing steps and fell

frequently. In order to get up from the floor, he would assist himself by

putting his hands on his knees. There was no family history of any

neuromuscular disease.
On examination,he was found to have weakness of his shoulders, pelvic

muscles and legs. His gait was unsteady and he could not hop on one

foot. There was a mild lumbar lordosis .His deep tendon reflexes were

decreased and he had minimal contracture of the Achilles tendons.

There was considerable pseudohypertrophy of the calves. no myotonia

could be elicited. Sensory examination was within normal limits.
Electromyography was suggestive of myopathy. laboratory studies

revealed a serum creatine phosphokinase(CPK) of 1600IU/l.
A biopsy of the quadriceps femoris was performed to confirm the

clinical diagnosis.
QUESTIONS
1. The most likely clinical diagnosis is
A. Duchenne muscular dystrophy
B. Limb-girdle muscular dystrophy
C.myotonic dystrophy
D. facioscapulohumenal muscular dystrophy
2. The pattern of inheritance in Duchenne muscular dystrophy is
A. autosomal dominant
B. autosomal recessive
C. x-linked recessive
D. variable
3. Good muscular biospy technique includes
A. selection of a moderately affected muscle
B. avoidance of sites previous injections,surgical incisions and

punctures by EMG needles
C.share dissection and use of an isometric clamp
D. all of the above
4. Patients with Duchenne muscular dystrophy usually die during the

second or third decades from
A. myositis
B. pulmonary disease
C. cardiac involvement
D. malignancies
5. If this child's disease fails to progress, if he remains ambulatory past

the age of 10 or 12 and if no electrocardiographic abnormalities appear,

one would have to revise the diagnosis to
A. limb-girdle muscular dystrophy
B. myotonic dystrophy
C. Becker muscular dystrophy
D. none of these
6. Younger male siblings with no overt clinical abnormalities may show
A. histological evidence of active muscular dystrophy
B. elevated serum muscle enzymes
C. histological evidence of an abortive form of muscular dystrophy
D. none of above
7. which of the following are useful in determining whether the mother

and any of her daughters are carriers?
A. Muscular boipsy
B. Serum muscle enzymes
C. Electromyography
D. All of these

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