Pancreonecrosis as a complication of biliary pancreatitis in a child with morbid obesity

D. A. Pyhteev, T. A. Bokova, L. M. Elin, O. G. Mikhaleva
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Abstract

Obesity in children is often accompanied by organic and functional changes on the part of the organs of the hepatobiliary system and pancreas. The article describes a clinical case of complicated course of gastrointestinal tract and pancreatic steatosis on the background of morbid obesity in a 15-year-old child with the development of choledocholithiasis, in turn, complicated by acute pancreatitis, pancreonecrosis, peritonitis and perforation of the colon. The tactics of child management, a set of diagnostic methods of examination, methods of surgical treatment are described. The necessity of early detection of both obesity itself and timely screening of its complications and comorbid pathology to prevent potentially life-threatening conditions is shown. Ultrasound of the abdominal cavity and biochemical blood analysis are mandatory for obese children. In cases of unclear genesis of jaundice, MRI is recommended to exclude obturation and abnormalities of the biliary tract. The choice of surgical tactics for the treatment of children with GI, acute pancreatitis is determined by the combination of complications, the condition of the child and the results of laboratory-radiation research methods.
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胰腺坏死是病态肥胖患儿胆源性胰腺炎的并发症之一
儿童肥胖往往伴随着肝胆系统和胰腺器官的器质性和功能性变化。文章描述了一个 15 岁儿童病态肥胖背景下胃肠道和胰腺脂肪变性并发症的临床病例,该病例出现胆总管结石,进而并发急性胰腺炎、胰腺坏死、腹膜炎和结肠穿孔。本文介绍了儿童管理策略、一整套检查诊断方法和手术治疗方法。说明了早期发现肥胖症本身和及时筛查肥胖症并发症和合并病症的必要性,以预防可能危及生命的病症。肥胖儿童必须进行腹腔超声波检查和血液生化分析。在黄疸成因不明的情况下,建议进行核磁共振检查,以排除胆道闭塞和异常。治疗消化道急性胰腺炎患儿的手术策略选择取决于并发症的综合情况、患儿的病情以及实验室放射研究方法的结果。
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