AN UNCOMMON CAUSE OF A COMMON COMPLAINT: ABDOMINAL PAIN AND ACUTE PANCREATITIS AS THE INITIAL CLINICAL MANIFESTATION OF SARCOIDOSIS

The incidence of acute pancreatitis (AP) in children has significantly increased in the past two decades. However, it can be associated with severe morbidity and mortality. Therefore it should be considered in every child presented with unexplained severe abdominal pain. The etiology, clinical manifestation, and course of acute pancreatitis in children are often different than in adults. Therefore the early and effective diagnosis of acute pancreatitis in children is challenging. In this review, we will discuss the etiology, clinical features and laboratory testing for the disease and also the management outlines of acute pancreatitis in children.Northern International Medical College Journal Vol.8(2) January 2017: 235-238

Download Full-text

Acute pancreatitis in IgA vasculitis

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2021.0025 ◽

2021 ◽

Vol 17 (2) ◽

pp. 164-167

Author(s):

Anna Fedorczak ◽

◽

Dorota Szałowska-Woźniak ◽

Krzysztof Zeman ◽

◽

...

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Gastrointestinal Tract ◽

Blood Vessels ◽

Clinical Manifestation ◽

Systemic Vasculitis ◽

Pancreatic Enzymes ◽

Iga Vasculitis ◽

Abdominal Symptoms ◽

Schonlein Purpura

IgA vasculitis, also known as the Henoch–Schönlein purpura, is the most common systemic vasculitis in children. Inflammation most often involves small blood vessels of the skin, joints, kidneys and the gastrointestinal tract, but other organs may also be involved. Acute pancreatitis is a rare clinical manifestation of IgA vasculitis. We present a case of a 12-year-old girl with cutaneous and abdominal symptoms, who was diagnosed with acute pancreatitis during IgA vasculitis. In patients with IgA vasculitis who report abdominal pain acute pancreatitis should be taken into account and pancreatic enzymes measurement should be considered.

Download Full-text

Recurrent Abdominal Pain in Childhood

Pediatrics in Review ◽

10.1542/pir.4.1.29 ◽

1982 ◽

Vol 4 (1) ◽

pp. 29-34

Author(s):

Giulio J. Barbero

Keyword(s):

Abdominal Pain ◽

Preschool Children ◽

Early Adolescence ◽

Recurrent Abdominal Pain ◽

Practical Approach ◽

Gastrointestinal Function ◽

Organic Disease ◽

Common Complaint ◽

Aged Child ◽

And Function

Recurrent abdominal pain (RAP) in childhood is a common complaint that may be difficult to diagnose and manage. Apley has reported that 10% of children have three or more episodes severe enough to impair activity and function over at least a three-month period. RAP appears less often in preschool children and, when present at earlier ages, it usually occurs in brief episodes rather than the more frequent and intense pattern that is characteristic of the school-aged child. RAP is more frequent in girls and is particularly prominent as a symptom in early adolescence. Occasional abdominal pain is a universal symptom in childhood and its significance is often difficult to assess. A practical approach is to determine the frequency, severity, and limitations produced by the pain before further exploration of its cause. DIAGNOSIS Recurrent abdominal pain in childhood can be divided into disturbances of gastrointestinal functions and a variety of pathologic disease or organic categories. A combination of the disturbance of function and other organic disease can also be present as the basis for the pain. Fewer than 10% to 15% of referred children reported in various studies have been found to have pain of organic origin. It is important to recognize that many patients and their parents are fearful of the pain as a symptom and are not easily able to incorporate a concept of disorder of a gastrointestinal function at the onset.

Download Full-text

Ceftriaxone-Induced Acute Pancreatitis

Annals of Pharmacotherapy ◽

10.1177/106002809302700108 ◽

1993 ◽

Vol 27 (1) ◽

pp. 36-37 ◽

Cited By ~ 18

Author(s):

Anthony E. Zimmermann ◽

Brian G. Katona ◽

Joginder S. Jodhka ◽

Richard B. Williams

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Acute Abdominal Pain ◽

Signs And Symptoms ◽

Etiologic Agent ◽

Antibiotic Regimen ◽

Intravenous Injections ◽

Case Summary ◽

Catheter Sepsis ◽

History Of

OBJECTIVE: To report a case of probable ceftriaxone-induced acute pancreatitis. CASE SUMMARY: A patient with a history of short-bowel syndrome on home total parenteral nutrition developed fever, chills, and right flank pain. She was diagnosed with gram-negative catheter sepsis and prescribed antibiotic therapy to be administered for four weeks. After completion of the first week of therapy, the antibiotic regimen was changed to intravenous injections of ceftriaxone to be given daily at home. Prior to discharge the patient developed acute abdominal pain, leukocytosis, jaundice, and markedly elevated lipase and amylase concentrations consistent with acute pancreatitis. The patient's condition improved upon discontinuation of the ceftriaxone and the remainder of her stay was uneventful. DISCUSSION: There is only one other case report in the literature of probable ceftriaxone-induced pancreatitis. Multiple other medications have been implicated in causing acute pancreatitis. The exact mechanism of this uncommon adverse effect of ceftriaxone is unknown. CONCLUSIONS: There was a temporal relationship between the development of this patient's signs and symptoms and the administration of ceftriaxone. We could not identify any other factors that may have been responsible for the development of her acute pancreatitis. Ceftriaxone should be considered as a possible etiologic agent in patients who present with acute abdominal pain and elevated lipase and amylase concentrations.

Download Full-text

Acute Pancreatitis: An Atypical Presentation

Case Reports in Gastroenterology ◽

10.1159/000475920 ◽

2017 ◽

Vol 11 (2) ◽

pp. 359-363 ◽

Cited By ~ 1

Author(s):

Omar Nadhem ◽

Omar Salh

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Reports ◽

Case Series ◽

Normal Serum ◽

Intravenous Fluids ◽

Serum Enzyme ◽

Serum Lipase ◽

Upper Abdominal ◽

Symptoms And Signs

Acute pancreatitis is an important cause of acute upper abdominal pain. Because its clinical features are similar to a number of other acute illnesses, it is difficult to make a diagnosis only on the basis of symptoms and signs. The diagnosis of acute pancreatitis is based on 2 of the following 3 criteria: (1) abdominal pain consistent with pancreatitis, (2) serum lipase and/or amylase ≥3 times the upper limit of normal, and (3) characteristic findings from abdominal imaging. The sensitivity and specificity of lipase in diagnosing acute pancreatitis are undisputed. However, normal lipase level should not exclude a pancreatitis diagnosis. In patients with atypical pancreatitis presentation, imaging is needed. We experienced two cases of acute pancreatitis associated with normal serum enzyme levels. Both patients were diagnosed based on clinical and radiological evidence. They were successfully treated with intravenous fluids and analgesics with clinical and laboratory improvement. The importance of this case series is the unlikely presentation of acute pancreatitis. We believe that more research is needed to determine the exact proportion of acute pancreatitis patients who first present with normal serum lipase, since similar cases have been seen in case reports.

Download Full-text

Acute Pancreatitis and Diabetic Ketoacidosis following L-Asparaginase/Prednisone Therapy in Acute Lymphoblastic Leukemia

Case Reports in Oncological Medicine ◽

10.1155/2014/139169 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

Dania Lizet Quintanilla-Flores ◽

Miguel Ángel Flores-Caballero ◽

René Rodríguez-Gutiérrez ◽

Héctor Eloy Tamez-Pérez ◽

José Gerardo González-González

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Acute Lymphoblastic Leukemia ◽

Diabetic Ketoacidosis ◽

Lymphoblastic Leukemia ◽

Remission Induction ◽

Contrast Enhanced ◽

Enhanced Computed Tomography ◽

Hispanic Male ◽

Contrast Enhanced Computed Tomography

Acute pancreatitis and diabetic ketoacidosis are unusual adverse events following chemotherapy based on L-asparaginase and prednisone as support treatment for acute lymphoblastic leukemia. We present the case of a 16-year-old Hispanic male patient, in remission induction therapy for acute lymphoblastic leukemia on treatment with mitoxantrone, vincristine, prednisone, and L-asparaginase. He was hospitalized complaining of abdominal pain, nausea, and vomiting. Hyperglycemia, acidosis, ketonuria, low bicarbonate levels, hyperamylasemia, and hyperlipasemia were documented, and the diagnosis of diabetic ketoacidosis was made. Because of uncertainty of the additional diagnosis of acute pancreatitis as the cause of abdominal pain, a contrast-enhanced computed tomography was performed resulting in a Balthazar C pancreatitis classification.

Download Full-text

A Case of Acute Hepatitis E Complicated by Acute Pancreatitis in Eastern India

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v12i2.513 ◽

2020 ◽

Vol 12 (2) ◽

Author(s):

Rudrajit P ◽

Shubhabrata D ◽

Sourav P ◽

Partha SC ◽

Jayati M ◽

...

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Hepatitis A ◽

Young Male ◽

Hepatitis E ◽

Uneventful Recovery ◽

Eastern India ◽

Acute Hepatitis E

Viral hepatitis may be occasionally associated with acute pancreatitis. Usually the patient presents with abdominal pain in the second or third week of illness. Hepatitis A or E viruses are mostly implicated. HEV related acute pancreatitis was first reported only 12 years ago. We report a case of a young male presenting with acute Hepatitis E infection complicated by pancreatitis. He had an uneventful recovery. This is probably the first report of this association from Eastern India.

Download Full-text

The Gynecologic Examination of the Prepubertal Child with Vulvovaginitis: Use of the Knee-Chest Position

PEDIATRICS ◽

10.1542/peds.65.4.758 ◽

1980 ◽

Vol 65 (4) ◽

pp. 758-760 ◽

Cited By ~ 1

Author(s):

S. Jean Emans ◽

D. P. Goldstein

Keyword(s):

Abdominal Pain ◽

Foreign Body ◽

Young Child ◽

Vaginal Bleeding ◽

Age Group ◽

X Ray ◽

Rectal Examination ◽

Good View ◽

Prepubertal Child ◽

Common Complaint

Vulvovaginitis is a common complaint in the prepubertal child. The proximity of the vagina to the anus and the thin uncornified vaginal epithelium make the young child especially susceptible to vulvovaginal infection. Not only is hygiene often suboptimal in this age group, but pinworm infestations, bubblebaths, harsh soaps, and tight-fitting nylon tights can all contribute to the vulvar irritation. Because children are frequently sent to gynecologists, traumatized by a rectal examination as the first part of the evaluation, or sent for an x-ray of the vagina with the hope of excluding a radiopaque foreign body, we believed it would be useful to present our approach to the gynecologic evaluation of the prepubertal child in which the kneechest position is used for visualizing the vagina. METHODS The evaluation of a prepubertal child with vulvovaginitis in the Gynecology Clinic of Children's Hospital is done in the following order: (1) history; (2) inspection of the perineum with the child supine; (3) visualization of the vagina and cervix in kneechest position; (4) cultures; and (5) a rectal examination in girls with vaginal bleeding or abdominal pain. The knee-chest position (Figure) provides a particularly good view of the vagina and cervix without instrumentation. The little girl is asked "to lie on her tummy with her bottom in the air." She is reassured that the examiner plans "to take a look" but "will not put anything inside her." The child rests her head to one side on folded arms and supports her remaining weight on bended knees (6 to 8 in apart).

Download Full-text

Acute pancreatitis

Oxford Textbook of Medicine ◽

10.1093/med/9780199204854.003.152401_update_001 ◽

2010 ◽

pp. 2557-2567

Author(s):

R. Carter ◽

C.J. McKay

Keyword(s):

Acute Pancreatitis ◽

Peptic Ulcer ◽

Gastric Ulcer ◽

Abdominal Pain ◽

Serum Amylase ◽

Perforated Peptic Ulcer ◽

Upper Limit ◽

Abdominal Emergencies ◽

Idiopathic Acute Pancreatitis ◽

Upper Abdominal

Acute pancreatitis affects 300 to 600 new patients per million population per year and is most commonly caused by gallstones or alcohol, but there are many other causes and associations. Careful imaging reveals that most so-called idiopathic acute pancreatitis is due to small (1–3 mm diameter) gallstones. Diagnosis is made by a combination of a typical presentation (upper abdominal pain and vomiting) in conjunction with raised serum amylase (> × 3 upper limit of normal) and/or lipase (> × 2 upper limit of normal). Several acute abdominal emergencies can mimic acute pancreatitis and may be associated with a raised serum amylase. These include perforated peptic ulcer (particularly perforated posterior gastric ulcer) and acute mesenteric ischaemia. In equivocal cases, a CT scan is indicated in order to exclude other causes and confirm the diagnosis....

Download Full-text