A Case of Severe Acute Pancreatitis in a Child who Received Continuous Arterial Infusion of Protease Inhibitor and Antibiotics Followed by Open Abscess Drainage Through the Retroperitoneal Route

Naoaki Sakata, Kazuhiko Shibuya, Tadayosi Abe, Yukio Mikami, Fuyuhiko Motoi, Junichiro Yamauchi, Makoto Sunamura, Kazunori Takeda and Seiki Matsuno

Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine

We report a case of severe acute pancreatitis in a 9-year-old boy. In 1998, the patient had pneumonia and received antibiotics for 2 weeks. One day after discharge, he suffered severe abdominal pain, and high serum amylase and hypoperfusion of the whole pancreas were observed. We undertook continuous infusion of protease inhibitor and antibiotics from the celiac artery in intensive care and he recovered. Seven weeks after initial onset, however, he suffered a high fever. Abdominal computed tomography (CT) showed a low-density area around the pancreatic body to the splenic hilum. Fine-needle aspiration confirmed bacterial infection by methicillin-resistant S. aureus (MRSA), for which we conducted debridement and open retroperitoneal abscess drainage. Case reports of severe acute pancreatitis in a child are few. Continuous arterial infusion of protease inhibitor and antibiotics appear to be effective for children and adults. The abscess was drained retroperitoneally for the retroperitoneal abscess.

Key words
severe acute pancreatitis in a child, continuous arterial infusion therapy, retroperitoneal drainage

Reprint requests
Kazuhiko Shibuya Department of Surgery, Division of Gastroenterological Surgery, Tohoku University Graduate School of Medicine
1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 JAPAN

Accepted
February 27, 2002

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