RESUMEN
A 6-year old girl was admitted to our hospital with high fever and right upper quadrant abdominal pain. At 5 years of age she had undergone allogeneic bone marrow transplantation because of intractable congenital pure red cell aplasia, after which she had asymptomatic cholelithiasis. Imaging studies and laboratory findings on admission suggested acute cholecystitis with a gallstone. The patient recovered completely after laparoscopic cholecystectomy was performed and was discharged on day 7 after the operation. Haemophilus influenzae grew on the aspirated purulent bile. It should be noted that H. influenzae can cause cholecystitis in children.
Asunto(s)
Colecistitis Aguda/diagnóstico , Colecistitis Aguda/microbiología , Colelitiasis/complicaciones , Infecciones por Haemophilus/complicaciones , Infecciones por Haemophilus/diagnóstico , Haemophilus influenzae/aislamiento & purificación , Niño , Colecistectomía , Colecistitis Aguda/cirugía , Femenino , Humanos , Imagen por Resonancia MagnéticaRESUMEN
Case: A 10-year-old boy sustained a blunt injury to the pancreatic neck with complete transection of the main pancreatic duct. Because endoscopic catheterization across the rupture site was not possible, an endoscopic nasopancreatic drain was inserted through the proximal pancreatic duct into the retroperitoneum. An emergency laparotomy was carried out, during which time the tube was used as a guide for identifying disrupted pancreatic ducts. Damaged tissue was removed, the proximal pancreatic duct was ligated, and a Roux-en-Y distal pancreaticojejunostomy was carried out. Outcome: The patient was discharged 49 days after surgery. Conclusion: Preoperative catheterization of the transected pancreatic duct is an option for detecting a disrupted main pancreatic duct.
RESUMEN
We report a 20-month-old girl with splenic abscess. The patient was admitted to our hospital because of persistent high fever and abdominal pain. Laboratory data showed leucocytosis and elevated C-reactive protein levels. Abdominal computed tomography showed multiple low-density lesions in the spleen. These findings were consistent with a diagnosis of splenic abscess. She was successfully treated with ultrasonographically guided percutaneous drainage for 11 days and intravenous antibiotic for 17 days. On culture, aspirated fluid from the abscess grew Streptococcus intermedius. This case illustrates that the differential diagnosis of unknown-focus infection in infants should include splenic abscess. We recommend conservative therapy (antibiotics and drainage) as first-line therapy for splenic abscess in pediatric patients, based on the importance of the immunological functions of the spleen.