Alsaedi Abdulaziz A, Bakkar Ayman A, Kamal Naglaa M, Althobiti Jwaher M
Pediatric Endocrinologist, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia Pediatric Hepatologist Faculty of Medicine, Cairo University, Cairo, Egypt Pediatric Hepatologist Al-Hada Armed Forces Hospital, Taif, Saudi Arabia Pediatric Resident, Al-Hada Armed Forces Hospital, Taif, Saudi Arabia.
Medicine (Baltimore). 2017 Oct;96(40):e7949. doi: 10.1097/MD.0000000000007949.
Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy that can cause permanent brain damage. Consequently, optimal management is extremely important. Current pharmacologic and surgical treatment were available that included diazoxide and octreotides.
A 4 month old Saudi male patient diagnosed at our hospital as CHI, treated with near total pancreatectomy and octreotide therapy of 30 mcg/kg/day presented with severe abdominal distension, vomiting and bloody diarrhea.
The patient was diagnosed as necrotising enterocolitis (NEC) associated with Rota virus infection which played together with octeriotides as risk factors for NEC.
Radiological investigations and multidisciplinary team management with endocrinologist, neonatologist, pediatric surgeon, and gastroenterologist.
Resolution of NEC with conservative medical management and was discharged after 1 month of hospital stay with follow up with all concerned sub specialties.
NEC can develop in patients treated with octreotides especially when associated with another risk factor such as rotavirus infection.
先天性高胰岛素血症（CHI）是婴儿持续性低血糖最常见的病因，可导致永久性脑损伤。因此，最佳治疗至关重要。目前有可用的药物和手术治疗方法，包括二氮嗪和奥曲肽。
一名4个月大的沙特男性患者在我院被诊断为CHI，接受了近全胰切除术和30微克/千克/天的奥曲肽治疗，出现严重腹胀、呕吐和血性腹泻。
该患者被诊断为与轮状病毒感染相关的坏死性小肠结肠炎（NEC），轮状病毒感染与奥曲肽共同作为NEC的危险因素。
进行放射学检查，并由内分泌学家、新生儿科医生、儿科外科医生和胃肠病学家组成的多学科团队进行管理。
通过保守药物治疗，NEC得到缓解，住院1个月后出院，并由所有相关专科进行随访。
接受奥曲肽治疗的患者可能会发生NEC，尤其是当与另一个危险因素如轮状病毒感染相关时。
