The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Study designWe retrospectively studied 56 patients who presented with AP to the pediatric department in Salmaniya Medical Complex between January 2006 and December 2017. Cases of chronic pancreatitis and ages above 12 years were excluded. The data concerned demographics, etiology, clinical data, hospital course, and outcomes. ResultsThe study included 56 patients aged a mean of 8.46 years (male:female -33:23). The average hospital stay was 7.68 days. Patients received parenteral feeds a mean of 2.77 days. All patients had an ultrasound, nine required CT scans (16.1%), and five MRIs (8.9%). There were 18 local complications (32.1%): pseudocysts (n=3, 5.36%), cholangitis (n=2, 3.6%), and edema (n=13, 23.2%). There were 23 intensive care unit (ICU) admissions (41.1%). No mortalities occurred but there were six recurrences (10.7%). Symptoms of abdominal pain, vomiting, fever, and nausea occurred in 100%, 57.1%, 35.7%, and 23.2% of patients, respectively. Etiologies were 41.1% biliary, 23.2% idiopathic, 19.6% traumatic, and 8.93% drug-induced. Leukocytes were elevated in 20 patients (35.7%), c-reactive protein (CRP) in five (8.93%), serum amylase in 45 (80.4%), and urinary amylase in all 56 patients (100%). ConclusionMost pediatric AP cases were attributed to biliary causes followed by trauma. Age was significantly correlated with complication rates (P=0.013). Abdominal pain was a more common symptom than vomiting. Leukocytosis was associated with ICU admissions. There was no significant relation between c-reactive protein, serum amylase, or urinary amylase, and complications or ICU admissions. Pediatric AP was selflimiting and there were no fatalities.
Foreign body ingestion is a commonly encountered problem in the pediatric population, which can be a source of severe distress to parents and caregivers. Certain foreign bodies such as magnets, bones, and button batteries can be particularly dangerous and lead to some serious complications like gastrointestinal obstruction, perforation, or bleeding depending on the nature of the foreign body, the location of impaction, and the period since ingestion. In this report, we discuss a case of a 23-month-old girl who ingested multiple magnets that got trapped within the appendix resulting in continuous vomiting.
A duplication cyst of the esophagus is the 2ndmost common congenital anomaly of the gastrointestinal tract. Although these benign cystic masses can be picked up routinely on a chest X-ray, patients may experience symptoms such as stridor or dysphagia corresponding to lesions within the neck or mediastinum. We present a rare case of a duplication cyst of esophagus in a 2-week-old female baby, which was surgically excised. Our aim in this case report is to raise awareness of this congenital disorder; especially when differential diagnoses such as acute respiratory distress syndrome (ARDS), failure to thrive, asthma, pneumonia, neuromuscular disorders and suspected foreign body inhalation have been ruled out in the pediatric patient.
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