Jha Saroj Kumar, Jha Pinky, Karki Pearlbiga
Department of Internal Medicine, Gajendra Narayan Singh Hospital, Rajbiraj.
Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Ann Med Surg (Lond). 2024 Aug 14;86(9):5639-5642. doi: 10.1097/MS9.0000000000002456. eCollection 2024 Sep.
Necrotizing pancreatitis is an uncommon diagnosis in pediatric patients. Early diagnosis is difficult as the presentation varies significantly. However, it should be in the differential diagnosis of abdominal pain in the pediatric age group.
An 8-year-old girl arrived with a 1-day history of vomiting, constipation, and abrupt, increasing epigastric discomfort. She didn't have any noteworthy family or medical background. Upon examination, she seemed to be afebrile but also had discomfort in her stomach and symptoms of dehydration. An enlarged pancreas with necrotizing pancreatitis was seen in the first imaging. She received intravenous fluids, antibiotics, and analgesics as a treatment for her acute severe pancreatitis diagnosis. Since the patient continued to have fever, meropenem was prescribed in place of ceftriaxone at first. After 10 days of uncomplicated hospitalization, she was released from the hospital.
Once rare, pediatric pancreatitis now affects 3-13 out of every 100 000 people yearly. Although it is uncommon (<1% in children), necrotizing pancreatitis can happen. Its causes are similar to those of acute pancreatitis, involving genetic abnormalities and certain drugs. Abdominal discomfort, fever, vomiting, and nausea are among the symptoms. Imaging methods like contrast-enhanced CT are used in diagnosis. Surgery has given way to less intrusive techniques like catheter drainage as a form of treatment. Surgery is seldom required in pediatric instances, which are often handled conservatively.
Childhood necrotizing pancreatitis is uncommon but dangerous; prompt diagnosis and prompt treatment are essential.
坏死性胰腺炎在儿科患者中是一种不常见的诊断。由于临床表现差异很大,早期诊断困难。然而,在儿科年龄组腹痛的鉴别诊断中应考虑到它。
一名8岁女孩前来就诊,有1天呕吐、便秘病史,且突发上腹部不适并逐渐加重。她没有任何值得注意的家族史或病史。检查时,她似乎没有发热,但有胃部不适和脱水症状。首次影像学检查发现胰腺肿大并伴有坏死性胰腺炎。她接受了静脉输液、抗生素和镇痛药治疗,诊断为急性重症胰腺炎。由于患者持续发热,起初用美罗培南代替头孢曲松。经过10天无并发症的住院治疗后,她出院了。
儿科胰腺炎曾经很罕见,现在每年每10万人中有3 - 13人受其影响。虽然它不常见(儿童中<1%),但坏死性胰腺炎是可能发生的。其病因与急性胰腺炎相似,包括基因异常和某些药物。症状包括腹部不适、发热、呕吐和恶心。诊断采用对比增强CT等影像学方法。治疗方面,手术已被导管引流等侵入性较小的技术所取代。儿科病例很少需要手术,通常采用保守治疗。
儿童坏死性胰腺炎虽不常见但很危险;及时诊断和及时治疗至关重要。