Buntain W L
Am Surg. 1985 Apr;51(4):180-8.
Chronic intermittent abdominal pain in childhood, reported to afflict nine to 12 per cent of all children, is an enigma of such magnitude that more than 30 per cent of these patients reach adulthood with persistent problems and no definitive diagnosis. This report discusses 20 children with such pain (9 girls and 11 boys) in whom routine diagnostic evaluation failed to identify the etiology. Selected special diagnostic studies and considerable suspicion for chronic pancreatitis prompted surgical intervention in three patients. Two were unsuspected and identified at celiotomy as having pancreatitis. The morphine-neostigmine evocative test, modified in some cases to confirm its usefulness, was helpful, accurate, and definitive in all 13 patients on whom it was used. Eighteen patients were confirmed surgically to have pancreatic disease, and two patients are unoperated with continued pancreatic pain. Ductal pathology was believed present in all. Of 18 patients operated, 11 patients are asymptomatic, five patients are improved, and two patients are considered failures 6 months to 10 years following surgery.
据报道，儿童慢性间歇性腹痛在所有儿童中发病率为9%至12%，是一个非常棘手的难题，超过30%的此类患儿成年后仍有持续问题且未得到明确诊断。本报告讨论了20例有此类疼痛的儿童（9名女孩和11名男孩），其常规诊断评估未能明确病因。选定的特殊诊断研究以及对慢性胰腺炎的高度怀疑促使对3例患者进行了手术干预。其中2例在剖腹手术中意外发现患有胰腺炎。吗啡-新斯的明激发试验在某些情况下进行了改良以证实其有效性，在所有13例接受该试验的患者中均有帮助、准确且具有决定性意义。18例患者经手术证实患有胰腺疾病，2例未接受手术，仍有持续性胰腺疼痛。所有患者均被认为存在导管病变。在18例接受手术的患者中，11例无症状，5例病情改善，2例在术后6个月至10年被认为手术失败。
