Chronic pancreatitis in children: treat like an adult?
Miguel Paiva PereiraFilipa SantosAna Serrão NetoJorge CanenaPublished in: BMJ case reports (2019)
A 15-year-old boy with a medical background of obesity, familial hyperlipidemia and acute recurrent pancreatitis, presented to emergency department reporting a 3-day course of periumbilical abdominal pain and nausea. Pain was noticed on epigastric palpation. Laboratory evaluation revealed leucocytosis, neutrophilia and pancreatic enzymes elevation more than three times the upper limit of normal. An acute recurrence of pancreatitis was diagnosed, was admitted to the hospital, being discharged after 5 days. Four days after, he was readmitted because of symptoms recurrence. Elevation of transaminases, gamma-glutamyltransferase (GGT) and direct bilirubin were noticed. Pancreatic enzymes still elevated but lower than in the previous episode. An endoscopic ultrasound revealed a Wirsung with a cephalic stricture and diffuse structural abnormalities suggestive of chronic pancreatitis. The patients was submitted to endotherapy with several sessions of endoscopic retrograde cholangiopancreatography including stenting and pancreatoscopy with marked clinical and imaging improvement. A genetic variant was identified.
Keyphrases
- emergency department
- liver failure
- ultrasound guided
- abdominal pain
- end stage renal disease
- respiratory failure
- healthcare
- adverse drug
- high resolution
- chronic pain
- ejection fraction
- drug induced
- newly diagnosed
- single cell
- metabolic syndrome
- type diabetes
- young adults
- chronic kidney disease
- weight loss
- prognostic factors
- magnetic resonance imaging
- aortic dissection
- pain management
- weight gain
- high fat diet
- peritoneal dialysis
- spinal cord
- low grade
- free survival
- adipose tissue
- high fat diet induced
- gene expression
- early onset
- patient reported outcomes
- coronary artery disease
- body mass index
- neuropathic pain
- mass spectrometry
- mechanical ventilation
- sleep quality
- chemotherapy induced
- breast reconstruction
- contrast enhanced ultrasound