Abstract

Case Report

A rare case of acute necrotising pancreatitis in a paediatric patient

Lizeri Jansen*, Gabrielle Colleran, Ikechukwu Okafor and Nuala Quinn

Published: 08 December, 2020 | Volume 3 - Issue 1 | Pages: 061-063

The diagnosis of acute necrotising pancreatitis is a rare event in the Paediatric Emergency Department (ED).

We report a case of acute pancreatitis in a paediatric patient, diagnosed in our ED, a tertiary level paediatric hospital.

This child presented with vague symptoms of constipation, abdominal pain and back pain, and on clinical examination had a distended abdomen with peritonism. She rapidly deteriorated and needed aggressive fluid resuscitation in the ED for treatment of septic shock. The diagnosis of acute pancreatitis (AP) was only considered once elevated amylase levels were apparent.

Whilst AP is an important differential diagnosis in a patient who is presenting with acute abdominal symptoms, the diagnosis in children in particular is seldom and thus easily overlooked in the previously healthy child.

Read Full Article HTML DOI: 10.29328/journal.japch.1001020 Cite this Article Read Full Article PDF

Keywords:

Child presenting with acute abdominal pain

References

  1. Valabrega S, Bersigotti L, Antolino L, Aurello P, Tomassini F, et al. Pediatric Pancreatitis: Not a Rare Entity, Pancreatitis, Dmitry Victorovich Garbuzenko. IntechOpen. 2019. https://www.intechopen.com/books/pancreatitis/pediatric-pancreatitis-not-a-rare-entity
  2. Whitcomb DC, Lowe ME. Pancreatitis: Acute and chronic. In: Kleinman RE, Sanderson IR, Goulet O, et al., editors. Walker’s Pediatric gastrointestinal disease. Hamilton: BC Decker Inc; 2008; 1213–1220.
  3. Nydegger Couper RT, Oliver MR. Childhood pancreatitis. J Gastroenterol Hepatol. 2006; 21: 499–509. PubMed: https://pubmed.ncbi.nlm.nih.gov/16638090/
  4. Benifla M, Weizman Z. Acute pancreatitis in childhood: analysis of literature data. J Clin Gastroenterol. 2003; 37: 169–172. PubMed: https://pubmed.ncbi.nlm.nih.gov/12869890/
  5. Werlin SL, Kugathasan S, Frautschy BC. Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003; 37: 591–595. PubMed: https://pubmed.ncbi.nlm.nih.gov/14581803/
  6. Ziegler DW, Long JA, Philippart AI, Klein MD. Pancreatitis in childhood. Experience with 49 patients. Ann Surg. 1988; 207: 257–261. PubMed: https://pubmed.ncbi.nlm.nih.gov/3345113/
  7. Agarwal N, Pitchumoni CS, Sivaprasad AV. Evaluating tests for acute pancreatitis. Am J Gastroenterol. 1990; 85: 356–366. PubMed: https://pubmed.ncbi.nlm.nih.gov/2183590/
  8. Abu-El-Haija M, Kumar S, Quiros JA, Balakrishnan K, Barth B, et al. Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2018; 66: 159-176. PubMed: https://pubmed.ncbi.nlm.nih.gov/29280782/
  9. Stein GN, Kalser MH, Sarian NN, Finkelstein A. An evaluation of the roentgen changes in acute pancreatitis: correlation with clinical findings. Gastroenterology. 1959; 36: 354–361. https://pubmed.ncbi.nlm.nih.gov/13640153/
  10. Pickhardt PJ. The colon cutoff sign. Radiology. 2000; 215: 387–389. PubMed: https://pubmed.ncbi.nlm.nih.gov/10796912/
  11. Silverstein W, Isikoff MB, Hill MC, Barkin J. Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography. AJR Am J Roentgenol. 1981; 137: 497–502. PubMed: https://pubmed.ncbi.nlm.nih.gov/7025598/
  12. Lautz TB, Turkel G, Radhakrishnan J, Wyers M, Chin AC. Utility of the computed tomography severity index (Balthazar score) in children with acute pancreatitis. J Pediatr Surg. 2012; 47: 1185–1191. PubMed: https://pubmed.ncbi.nlm.nih.gov/22703791/
  13. Shimizu T, Suzuki R, Yamashiro Y, Segawa O, Yamataka A, et al. Magnetic resonance cholangiopancreatography in assessing the cause of acute pancreatitis in children. Pancreas. 2001; 22: 196–199. PubMed: https://pubmed.ncbi.nlm.nih.gov/11249076/
  14. Alonso JV, Turpie J, Farhad I, Ruffino G. Protocols for Point-of-Care-Ultrasound (POCUS) in a Patient with Sepsis; An Algorithmic Approach. Bull Emerg Trauma. 2019; 7: 67-71. PubMed: https://pubmed.ncbi.nlm.nih.gov/30719469/

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