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pediatric recurrent abdominal pain

Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
Natasha Hansraj, Shannon M Larabee, Kimberly M Lumpkins
We report a case of an 11-year with recurrent episodes of abdominal pain and vomiting. Diagnostic laparoscopy during a severe episode demonstrated an anomalous blood vessel incompletely encircling the bowel, leading to transient partial small bowel obstruction. This likely represents a remnant vessel from the omphalomesenteric duct. Recurrent abdominal pain and vomiting in the pediatric population requires careful history and physical exam, and a willingness to entertain unusual diagnoses.
December 1, 2016: Journal of Surgical Case Reports
Michelle Lai, Brian A Coakley, Eric M Webber, Ran D Goldman
Intussusception is a pediatric abdominal emergency in early childhood involving telescoping of 1 part of the bowel into another part. In most children, the condition is idiopathic with no identifiable lead point. Meckel diverticulum is the most common lead point, followed by polyps and duplication cysts. We describe a case of a boy with intussusception caused by a duplication cyst that was drawn retrograde through the ileocecal valve. The patient presented after a 3-month period of symptomatology and had been considered to have constipation before signs of intestinal obstruction developed...
November 19, 2016: Pediatric Emergency Care
Manisha Balwani, Preeti Singh, Anju Seth, Ekta Malik Debnath, Hetanshi Naik, Dana Doheny, Brenden Chen, Makiko Yasuda, Robert J Desnick
Acute Intermittent Porphyria (AIP), an autosomal dominant inborn error of heme metabolism, typically presents in adulthood, most often in women in the reproductive age group. There are limited reports on the clinical presentation in children, and in contrast to the adults, most of the reported pediatric cases are male. While acute abdominal pain is the most common presenting symptom in children, seizures are commonly seen and may precede the diagnosis of AIP. As an example, we report a 9year old developmentally normal pre-pubertal boy who presented with acute abdominal pain, vomiting and constipation followed by hyponatremia, seizures, weakness and neuropathy...
October 15, 2016: Molecular Genetics and Metabolism
Gea A Holtman, Yvonne Lisman-van Leeuwen, Boudewijn J Kollen, Obbe F Norbruis, Johanna C Escher, Angelika Kindermann, Yolanda B de Rijke, Patrick F van Rheenen, Marjolein Y Berger
PURPOSE: In specialist care, fecal calprotectin (FCal) is a commonly used noninvasive diagnostic test for ruling out inflammatory bowel disease (IBD) in children with chronic gastrointestinal symptoms. The aim of this study was to evaluate the diagnostic accuracy of FCal for IBD in symptomatic children in primary care. METHODS: We studied 2 prospective cohorts of children with chronic diarrhea, recurrent abdominal pain, or both: children initially seen in primary care (primary care cohort) and children referred to specialist care (referred cohort)...
September 2016: Annals of Family Medicine
Toshiyuki Hikita
Prevalence of abdominal migraine (AM) and recurrent abdominal pain (RAP) was evaluated in patients who visited Hikita Pediatric Clinic between May 2010 and April 2015. Patient data were collected prospectively using a questionnaire. Out of a total of 3611 cases, observed prevalence was 2.44% for repeated abdominal pain over a period of ≥3 months, 1.47% for RAP, and 0.19% for AM. Duration of abdominal pain was longer for AM than for non-AM RAP. Certain clinical features were significantly different between AM and non-AM RAP...
July 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Claudio Romano, Simona Valenti, Sabrina Cardile, Marc A Benninga
As defined by Rome III, there are 4 abdominal pain-related functional gastrointestinal disorders in children: irritable bowel syndrome, functional dyspepsia (FD), abdominal migraine, and functional abdominal pain. Dyspepsia is a constellation of symptoms referable to the gastroduodenal region of the upper gastrointestinal tract. FD refers to dyspeptic symptoms that cannot currently be explained by an organic cause, and affects 25% to 40% of the adult population over a lifetime. In children, this condition results in increased specialist consultations, with reported prevalence between 3% and 27%...
December 2016: Journal of Pediatric Gastroenterology and Nutrition
Nobutomo Saito, Mitsuyoshi Suzuki, Yumiko Sakurai, Satoshi Nakano, Nakayuki Naritaka, Kei Minowa, Jin K Sai, Toshiaki Shimizu
OBJECTIVES: Causes of acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP) are sometimes difficult to determine in children. In such patients, genetic analysis may prove helpful. The present study analyzed mutations of cationic trypsinogen (PRSS1), serine protease inhibitor Kazal type 1 (SPINK1), chymotrypsin C (CTRC), and carboxypeptidase A1 (CPA1) and investigated the clinical features of children with these mutations. METHODS: Genetic analyses of mutations in these 4 genes were conducted in 128 patients with ARP or CP...
October 2016: Journal of Pediatric Gastroenterology and Nutrition
David Kim, Sonia A Butterworth, Ran D Goldman
QUESTION: While the diagnosis of acute appendicitis is relatively straightforward, chronic appendicitis is an entity that can be controversial and is often misdiagnosed. How and when should clinicians be investigating chronic appendicitis as a cause of chronic and recurrent abdominal pain in the pediatric population? ANSWER: Chronic appendicitis is a long-standing inflammation or fibrosis of the appendix that presents clinically as prolonged or intermittent abdominal pain...
June 2016: Canadian Family Physician Médecin de Famille Canadien
Oleksii Slepov, Sergii Kurinnyi, Oleksii Ponomarenko, Mikhailo Migur
BACKGROUND: Due to scarcity of congenital diaphragmatic hearnias of Morgagni (CDHM), non-specific clinical presentation in the pediatric age group, we aimed to investigate the incidence, clinical manifestations, anatomical characteristics, and develop diagnostic algorithm and treatment of CDHM in children. MATERIALS AND METHODS: The patients' records of children with CDHM treated in our hospital during past 20 years were retrospectively reviewed for the age at diagnosis, gender, clinical findings, anatomical features, operative details and outcome...
April 2016: African Journal of Paediatric Surgery: AJPS
Lucia Radillo, Andrea Taddio, Sergio Ghirardo, Matteo Bramuzzo, Federica Pederiva, Massimo Maschio, Egidio Barbi
Wandering spleen is a rare condition, typically not only due to embryological defects of the splenic ligaments, but also secondary to trauma and splenomegaly. The most common presentation is acute abdomen with a mobile abdominal mass or recurrent abdominal pain. However, the spleen may be temporary in its normal position, and patients could be asymptomatic. A familiarity, if present, strengthens the diagnostic suspect.Abdominal ultrasonography and computed tomography are the examination of choice, and the management is surgical...
September 2016: Pediatric Emergency Care
Ilaria Trecroci, Giuliana Morabito, Claudio Romano, Ignazio Salamone
BACKGROUND: Gastric volvulus is a clinically significant cause of acute or recurrent abdominal pain and chronic vomiting in children. Since related clinical symptoms are nonspecific, clinicians often refer to radiologists for a diagnostic evaluation. Early diagnosis is crucial to prevent life-threatening complications of prolonged volvulus, such as intestinal ischemia, infarction, strangulation, necrosis, and perforation that may require immediate surgical treatment. In this report, we describe clinical and radiological criteria for diagnosis of gastric volvulus in children...
2016: Journal of Medical Case Reports
Fabao Hao, Hongjie Guo, Qianfu Luo, Chunbao Guo
BACKGROUND: Approximately 10% of patients with acute pancreatitis (AP) progress to chronic pancreatitis. Little is known about the factors that affect recurrence of pancreatitis after an initial episode. We retrospectively investigated patients with AP, focusing on their outcomes and the predictors for disease progression. METHODS: Between July 2003 and June 2015, we retrospectively enrolled first-time AP patients with medical records on disease etiology, severity (according to the Atlanta classifications), and recurrence of AP...
May 15, 2016: Journal of Surgical Research
Sabine Irtan, Louise Galmiche-Rolland, Caroline Elie, Daniel Orbach, Alain Sauvanet, Dominique Elias, Florent Guérin, Carole Coze, Cécile Faure-Conter, François Becmeur, Martine Demarche, René Benoît Galifer, Marie Agnès Galloy, Guillaume Podevin, Didier Aubert, Christian Piolat, Pascal De Lagausie, Sabine Sarnacki
BACKGROUND: Solid pseudopapillary neoplasms of the pancreas (SPPN) can relapse very late, but little is known about risk factors for recurrence and optimal treatment. We aimed to identify risk factors for recurrence and to analyze treatment modalities in all French pediatric cases of SPPN over the past 20 years. MATERIAL AND METHODS: Data were collected from pediatric oncologists and surgeons, and also from adult pancreatic surgeons in order to identify late recurrences...
September 2016: Pediatric Blood & Cancer
Paulette I Abbas, Jennifer E Dietrich, Jessica A Francis, Mary L Brandt, Darrell L Cass, Monica E Lopez
STUDY OBJECTIVE: To evaluate outcomes of children after ovarian-sparing surgery (OSS) for non-neoplastic and benign neoplastic ovarian lesions. DESIGN: Retrospective cohort study from January 2003 to January 2012. SETTING: Single, high-volume, tertiary care hospital. PARTICIPANTS: Children 18 years of age and younger. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Postoperative complications and tumor recurrence after OSS...
October 2016: Journal of Pediatric and Adolescent Gynecology
Chhagan Bihari, Archana Rastogi, S Rajesh, Ankur Arora, Asit Arora, Nikhil Kumar
Lymphangiomas are benign hamartomatous malformations which can arise either from congenitally sequestered lymphatic channels or due to acquired obstruction caused by fibrosis of lymph channels. They are common in the pediatric age group in the soft tissue of neck and the axilla. Abdominal lymphangiomas are rare; even rarer is the primary involvement of pancreas. It occurs more frequently in females and is often located in the distal pancreas. The authors report the case of cystic lymphangioma of pancreas in a 26-year old female presenting with recurrent episodes of upper abdominal pain that was treated with laparoscopic cyst excision...
March 2016: Indian Journal of Surgical Oncology
Soma Kumar, Chee Y Ooi, Steven Werlin, Maisam Abu-El-Haija, Bradley Barth, Melena D Bellin, Peter R Durie, Douglas S Fishman, Steven D Freedman, Cheryl Gariepy, Matthew J Giefer, Tanja Gonska, Melvin B Heyman, Ryan Himes, Sohail Z Husain, Tom K Lin, Mark E Lowe, Veronique Morinville, Joseph J Palermo, John F Pohl, Sarah Jane Schwarzenberg, David Troendle, Michael Wilschanski, M Bridget Zimmerman, Aliye Uc
IMPORTANCE: Pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) are poorly understood. OBJECTIVE: To characterize and identify risk factors associated with ARP and CP in childhood. DESIGN, SETTING, AND PARTICIPANTS: A multinational cross-sectional study of children with ARP or CP at the time of enrollment to the INSPPIRE (International Study Group of Pediatric Pancreatitis: In Search for a Cure) study at participant institutions of the INSPPIRE Consortium...
June 1, 2016: JAMA Pediatrics
Luana Amancio, Maira Fedrizzi, Nilzete Liberato Bresolin, Maria Goretti Moreira Guimarães Penido
INTRODUCTION: Pediatric urolithiasis has become more prevalent in recent decades, with high recurrence rates and considerable morbidity. Most children with idiopathic urolithiasis have an underlying metabolic abnormality and proper research provides therapeutic interventions to reduce the formation of new stones and its complications. OBJECTIVE: To identify demographic and clinical characteristics of pediatric urolithiasis, etiology, treatment management, disease recurrence and patient outcomes in a tertiary care pediatric hospital...
March 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
J Le Vaillant, L Pellerin, J Brouard, D Nimal-Cuvillon
AIM: Biological complications in adolescents' self-poisoning are not currently evaluated. The aim of this study was to describe the toxicological characteristics of suicide attempts, the ingested substances, and their complications to better prevent the risks associated with deliberate self-poisoning. MATERIALS AND METHODS: This was a descriptive, prospective, single-center study. It took place in the pediatric emergency, hospitalization, and intensive care unit of the Caen University Hospital...
May 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Cécile-Audrey Durel, Achille Aouba, Boris Bienvenu, Samuel Deshayes, Brigitte Coppéré, Bruno Gombert, Cécile Acquaviva-Bourdain, Eric Hachulla, Frédéric Lecomte, Isabelle Touitou, Jacques Ninet, Jean-Baptiste Philit, Laurent Messer, Marc Brouillard, Marie-Hélène Girard-Madoux, Michel Moutschen, Nadia Raison-Peyron, Pascal Hutin, Pierre Duffau, Pierre Trolliet, Pierre-Yves Hatron, Philippe Heudier, Ramiro Cevallos, Thierry Lequerré, Valentine Brousse, Vincent Lesire, Sylvain Audia, Delphine Maucort-Boulch, Laurence Cuisset, Arnaud Hot
The aim of this study was to describe the clinical and biological features of Mevalonate kinase deficiency (MKD) in patients diagnosed in adulthood. This is a French and Belgian observational retrospective study from 2000 to 2014. To constitute the cohort, we cross-check the genetic and biochemical databases. The clinical, enzymatic, and genetic data were gathered from medical records. Twenty-three patients were analyzed. The mean age at diagnosis was 40 years, with a mean age at onset of symptoms of 3 years...
March 2016: Medicine (Baltimore)
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