Buntain W L, Buonocore E, Royal S A
Am J Surg. 1986 Dec;152(6):628-37. doi: 10.1016/0002-9610(86)90439-3.
The true incidence and cause of chronic recurrent pancreatitis in children remains enigmatic because little is known about its early natural history, it is considered only infrequently, and diagnosis is difficult. Chronic recurrent abdominal pain in children continues to be common. To help evaluate the possibility that such pain is related to chronic recurrent pancreatitis, this study used the morphine-prostigmine pancreatic evocative test with the recent addition of concomitant pancreatic ultrasonography to evaluate ductal activity. Fourteen of 67 children studied had positive results and 13 underwent operation, which included 2 partial pancreatectomies and 12 sphincteroplasties in 12 patients. At last follow-up seven were asymptomatic, five were significantly improved, and one who had pancreatography only continued to have pain. The remaining patient, who has not yet operated on, continues to have pain. This series supports the use of the morphine-prostigmine test to determine which patients have abdominal pain that is potentially related to pancreatitis and which patients would benefit from operation.
儿童慢性复发性胰腺炎的真实发病率及病因仍不清楚，因为人们对其早期自然病史知之甚少，这种疾病很少被考虑到，且诊断困难。儿童慢性复发性腹痛仍然很常见。为了评估这种疼痛与慢性复发性胰腺炎相关的可能性，本研究采用吗啡-新斯的明胰腺激发试验，并最近增加了胰腺超声检查以评估导管活性。在研究的67名儿童中，14名结果呈阳性，其中13名接受了手术，包括2例部分胰腺切除术和12例患者的12次括约肌成形术。在最后一次随访时，7名无症状，5名明显改善，仅接受胰腺造影的1名患者仍有疼痛。其余未接受手术的患者仍有疼痛。该系列研究支持使用吗啡-新斯的明试验来确定哪些患者的腹痛可能与胰腺炎相关，以及哪些患者将从手术中获益。
