Ladipo-Ajayi Oluwaseun, Ihediwa George, Akinjo Andrea O, Awolola Nicholas A, Elebute Olumide A, Ademuyiwa Adesoji E
Paediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Nigeria.
Department of Anatomic & Molecular Pathology, College of Medicine, University of Lagos, Nigeria.
Int J Surg Case Rep. 2020;77:686-691. doi: 10.1016/j.ijscr.2020.11.114. Epub 2020 Nov 24.
Pancreatitis is a dire clinical diagnosis with variable presentation in the paediatric population. Moreover, neonatal pancreatitis has been rarely reported in the English literature.
A newborn, product of a poorly supervised, pre-term gestation with pre-natally diagnosed intestinal obstruction, and post-natal clinical features of jaundice, vomiting, abdominal distension, aphonation and suspected chromosomal abnormalities. There was maternal hepatitis which was untreated. Diagnosed as duodenal atresia, the baby was investigated, resuscitated and had surgery. Intra-operative findings were of an omental bubble, duodenal stenosis with annular pancreas, coagulative necrosis of the pancreas and multiple intra peritoneal cheesy deposits. Following an unfortunate demise, autopsy confirmed pancreatitis and multiple congenital abnormalities.
Paediatric caregivers should be aware of the possibility of neonatal pancreatitis in jaundiced newborns with intestinal obstruction especially with a background of maternal viraemia.
A constellation of unusual presentations as highlighted could be a pointer to an emerging syndrome. All paediatric caregivers should entertain a high index of suspicion of pancreatitis in such a case, investigate and expedite appropriate interventions to prevent mortality.
胰腺炎是一种严重的临床诊断，在儿科人群中表现多样。此外，新生儿胰腺炎在英文文献中鲜有报道。
一名新生儿，是监管不善的早产妊娠产物，产前诊断为肠梗阻，产后有黄疸、呕吐、腹胀、失声及疑似染色体异常等临床特征。母亲患有未治疗的肝炎。该婴儿被诊断为十二指肠闭锁，接受了检查、复苏并进行了手术。术中发现有网膜气泡、伴有环状胰腺的十二指肠狭窄、胰腺凝固性坏死以及多个腹腔内奶酪样沉积物。不幸死亡后，尸检证实为胰腺炎和多种先天性异常。
儿科护理人员应意识到，对于患有肠梗阻的黄疸新生儿，尤其是有母亲病毒血症背景的新生儿，存在新生儿胰腺炎的可能性。
如文中所强调的一系列不寻常表现可能提示一种新出现的综合征。所有儿科护理人员在这种情况下都应高度怀疑胰腺炎，进行检查并迅速采取适当干预措施以防止死亡。
