Shubietah Abdalhakim R M, Deek Soud M S, Zakaria Zaid, Saleh Fares, Abdulkareemsrour Abdulmotti, Naser Mohamad, Dibas Yazan M S, Jabri Mohammed S M, AbuMohsen Haytham M A
Palestinian Ministry of Health, Darwish Nazzal Government Hospital, Qalqilya.
Palestinian Ministry of Health.
Ann Med Surg (Lond). 2023 May 9;85(6):3113-3118. doi: 10.1097/MS9.0000000000000792. eCollection 2023 Jun.
Children with acute pancreatitis may experience abdominal pain; the causes of which include anatomical abnormalities and medications. The rare anatomical etiology of duodenal duplication cyst is typically asymptomatic and discovered incidentally. The authors present a unique case of a Whipple-operated duodenal duplication cyst.
The authors present the case of a 12-year-old Arab male who was admitted to our hospital with worsening, severe epigastric pain, stabbing in nature, and radiating to the back, suggestive of acute pancreatitis. Serum lipase levels were significantly elevated. The patient received appropriate care. His medical history is notable for multiple bouts of pancreatitis in the last 18 months. Previous investigations at other hospitals were mostly unrevealing. A more extensive workup was performed, revealing a duodenal cystic structure. This led to the diagnosis of a duodenal duplication cyst. The Whipple procedure was decided upon due to his recurrent pancreatitis, which caused fibrotic adhesions and anatomic region distortion. The patient underwent surgery and recovered uneventfully.
Acute pancreatitis in children is frequent and can be caused by unrecognized duodenal duplication cysts. When symptomatic, the majority present with vague abdominal pain. Despite using ultrasound as an adjunctive for diagnosis, the cyst might not become apparent until the condition has progressed to an advanced stage. A delayed diagnosis may result in complications necessitating risky surgeries.
Children with recurrent pancreatitis should be evaluated for a duodenal duplication cyst. Early use of computed tomography scans may be necessary to identify the cause and spare the patient from risky procedures like Whipple surgery.
患有急性胰腺炎的儿童可能会经历腹痛；其病因包括解剖学异常和药物。十二指肠重复囊肿这种罕见的解剖学病因通常无症状，多为偶然发现。作者介绍了一例接受惠普尔手术的十二指肠重复囊肿的独特病例。
作者介绍了一名12岁阿拉伯男性的病例，该患者因上腹部疼痛加重、呈刺痛性质且放射至背部而入住我院，提示急性胰腺炎。血清脂肪酶水平显著升高。患者接受了适当的治疗。他的病史值得注意的是在过去18个月内有多次胰腺炎发作。此前在其他医院的检查大多无结果。进行了更广泛的检查，发现了一个十二指肠囊性结构。这导致诊断为十二指肠重复囊肿。由于他反复胰腺炎导致纤维化粘连和解剖区域变形，决定采用惠普尔手术。患者接受了手术，恢复顺利。
儿童急性胰腺炎很常见，可能由未被识别的十二指肠重复囊肿引起。有症状时，大多数表现为模糊的腹痛。尽管使用超声作为辅助诊断手段，但囊肿可能直到病情发展到晚期才会显现。延迟诊断可能导致需要进行有风险手术的并发症。
患有复发性胰腺炎的儿童应评估是否存在十二指肠重复囊肿。可能有必要早期使用计算机断层扫描来确定病因，使患者避免像惠普尔手术这样的有风险的手术。
