Sonographic presentation of chronic pancreatitis complicated with acute duodenal obstruction in a battered child
✍ Scribed by Ming-Hwa Chen; Chung-Hsiang Lee; Chen-Lang Wu; Min-Chiu Su; Wen-Haur Wu; Wen-Rong Yeh
- Publisher
- John Wiley and Sons
- Year
- 1994
- Tongue
- English
- Weight
- 440 KB
- Volume
- 22
- Category
- Article
- ISSN
- 0091-2751
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✦ Synopsis
Chronic pancreatitis, a rare disease in children, is usually secondary to underlying diseases such as hereditary pancreatitis, cystic fibrosis, hyperlipidemia, prolonged malnutrition, gallstones, or anomalies of the biliary-pancreatic duct system. We report a case of chronic pancreatitis complicated with acute duodenal obstruction resulting from long-term battery to the pancreas and prolonged malnutrition. Serial abdominal sonograms were performed to evaluate the sonographic spectrum of acute pancreatic head swelling superimposed on chronic pancreatitis. To the best of our knowledge, there are no other published reports describing chronic pancreatitis in children caused by long-term child abuse.
CASE REPORT
A 7-year-old boy was admitted to the hospital with complaints of severe bilious vomiting and abdominal pain for 5 days. Physical examination revealed abdominal tenderness over the epigastric area; there were no prominent external signs of trauma except the presence of bruises on his lower legs. Marked dehydration with sunken eyeballs and emaciation (body weight: 16 kg, less than 3% of normal) were noted. There was no fa- milial history of pancreatitis.
Laboratory studies revealed a normal hemogram, sodium: 124 meq/L, potassium: 2.5 meq/L, glucose: 106 mg/dL, and calcium: 10.2 mg/dL. The initial serum amylase was 99 IUIL, and repeated measurements of serum amylase were all within normal limits. Urinary amylase-creatinine ratio From the