Akut idiyopatik yineleyen pankreatit tanılı bir vaka
Çocuklarda akut pankreatit ender görülür. Klinik semptom ve bulguları tipik olmayabilir ve laboratuvar testleri yeteri kadar duyarlı değildir. Hastalığın etiyolojisi ise, sıklıkla saptanamaz. Bu makalede, kliniğimize şiddetli karın ağrısı ve kusma ile başvuran, laboratuvar değerlendirmesinde yüksek serum amilaz ve lipaz düzeyleri saptanan altı yaşında erkek hasta sunulmuştur. Hastanın öyküsinde yedi ay önce akut pankreatit tanısı ile başka bir hastanede yatarak tedavi gördüğü öğrenilmiştir. Hasta öyküsü, klinik ve laboratuvar bulguları sonucunda ‘akut idiopatik yineleyen pankreatit’ tanısı almıştır. Çocukluk döneminde sık rastlanan bir semptom olan karın ağrısı şikâyeti ile başvuran her hastada ve ayırıcı tanıda, akut pankreatit de düşünülmelidir.
Case report: Acute idiopathic recurrent pancreatitis
Acute pancreatitis is rare in the paediatric age group. The presenting clinical symptoms and signs may not be typical and the laboratory tests may not always be sensitive enough. The etiology of the disease is often unknown. Here, we present a six years old boy who was admitted to our clinic with symptomps of abdominal pain and vomiting, and who had increased serum amilase and lipase levels in laboratory evaluation. He had another acute pancreatitis attact seven months ago. With the reccurent history, clinical and laboratory findings we diagnosed “acute idiopathic recurrent pancreatitis”. In the differential diagnosis of abdominal pain, a common symptom of childhood, acute pancreatitis must be thought.
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- 1. Lopez M. The changing incidence of acute pancreatitis in children: a single-institution perspective. J Pediatr 2002; 140:622-4.
- 2. Claude CR, Silverman A, Alagille D, eds. Pediatric Clinical Gastroenterology, 4th ed. St. Louis, Missouri: Mosby 1995: 986-99.
- 3. Mathew P, Wyllie R, Caulfield M, Steffen R, Kay M. Chronic pancreatitis in late childhood and adolescence. Clin Pediatri (Phila). 1994; 33:88-94.
- 4. Lowe MF. Pancreatitis in childhood. Curr Gastroenterol Rep 2004; 6:240-6.
- 5. Stevan L. Werlin, Exocrine Pancreas. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson Textbook of Pediatrics 17th ed. Pennysylvania: Saunders 2004: 1298-304.
- 6. Nig S, Callahan MT, Taylor GA. Disorders of the pediatric pancreas: imaging features, Pediatr Radiol 2005; 35:358-73.
- 7. Cosentini A, Stranieri G, Capillo S. Acut pancreatitis in the paediatric age group: a personal experience. Eur Rev Med Pharmacol Sci 2005; 9:33-40.
- 8. Pezzilli R, Morselli-Labate AM, Castellano E, et al. Acute pancreatitis in children. An Italian multicentre study. Dig Liver Dis 2002; 34:343-8.
- 9. Banfila M, Weizman Z. Acute pancreatitis in childhood: analysis of literature data. J Clin Gastro-Enterol 2003; 37:169-72.
- 10. Me Gaughran JM, Kimble R, Upton J, George P. Hereditary pancreatitis in a family of AlHririginal descent. J Paediatr Child Health 2004; 40:487-9.
- 11. Jorgensen MT, Schaffolitzky de Muckadell OB. Hereditary Pancreatitis. Ugeskr Laeger 2003; 165:447-51.
- 12. Alvarez Calyayul G, Bremeso F, Merales JL. Acute pancreatitis In childhood. Rev Esp Enferm Dig 2003; 95:40-4,45-8.
- 13. Baezza-Herrera C, Velasco-Soria L, Mora-Hernandes F, et al. Acute pancreatitis in childhood. Is it the same disease in adults'? Cir Cir 2003; 71:434-9.
- 14. Saner G, Süoğlu Ö. Ekzokrin Pankreas hastalıkları Neyzi O, Ertuğrul T, eds. Pediatri Cilt 2. İstanbul, Nobel Tıp Kitabevleri 2002; 810-9.
- 15. Goh SK, Clıui CH, Jacobsen AS. Childhood acute pancreatitis in a children's hospital. Singapore Med J 2003; 44:453-6.
- 16. Davenport M. Acute and chronic pancreatitis. Indian J Pediatr 2002; 69:801-7.