Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Obstructive Jaundice Secondary to Traumatic Pancreatitis Treated with Percutaneous Transhepatic Biliary Drainage

경피경간담도배액술로 치료한 외상 급성 췌장염에 의한 폐쇄 황달

  • Park, Ji-Sook (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Baek, Jong-Geun (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Yeom, Jung-Sook (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Park, Eun-Sil (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Seo, Ji-Hyun (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Lim, Jea-Young (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Park, Chan-Hoo (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Woo, Hyang-Ok (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Youn, Hee-Shang (Department of Pediatrics, Gyeongsang National University School of Medicine) ;
  • Shin, Tae-Beom (Department of Radiology, Gyeongsang National University School of Medicine, Gyeongsang Institute of Health Science)
  • 박지숙 (경상대학교 의학전문대학원 소아과학교실) ;
  • 백종근 (경상대학교 의학전문대학원 소아과학교실) ;
  • 염정숙 (경상대학교 의학전문대학원 소아과학교실) ;
  • 박은실 (경상대학교 의학전문대학원 소아과학교실) ;
  • 서지현 (경상대학교 의학전문대학원 소아과학교실) ;
  • 임재영 (경상대학교 의학전문대학원 소아과학교실) ;
  • 박찬후 (경상대학교 의학전문대학원 소아과학교실) ;
  • 우향옥 (경상대학교 의학전문대학원 소아과학교실) ;
  • 윤희상 (경상대학교 의학전문대학원 소아과학교실) ;
  • 신태범 (경상대학교 의학전문대학원 영상의학교실, 건강과학연구원)
  • Received : 2010.08.07
  • Accepted : 2010.09.03
  • Published : 2010.09.30
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Abstract

Isolated pancreatic trauma and secondary obstructive jaundice in the pediatric population is unusual. Biliary tract obstruction can be a major cause of acute pancreatitis. We report a case of obstructive jaundice secondary to isolated traumatic acute pancreatitis in a previously healthy 32-month-old girl. In our case, secondary obstructive jaundice aggravated the pancreatic inflammation and was successfully treated with percutaneous transhepatic biliary drainage (PTBD).

소아에서 외상 급성 췌장염은 드물기는 하지만 주로 자전거 손잡이에 의한 복부 둔상으로 발생할 수 있다. 치료는 손상의 정도에 따라 개별화되며, 저자들에 따라 치료 방법에 차이를 보이지만 대부분 췌장 도관의 손상과 위치에 따라 결정된다. 외상 급성 췌장염의 합병증으로 췌장 거짓낭이 주로 발생하지만 저자들은 췌장염의 보존적 치료 경과 중 원위부 총담관의 협착과 담즙찌꺼기에 의한 담도 폐쇄를 경험하였고 경피경간담도 배액술로 성공적으로 치료하였기에 보고하는 바이다.

Keywords

References

  1. Lopez MJ. The changing incidence of acute pancreatitis in children: a single-institution perspective. J Pediatr 2002;140:622-4. https://doi.org/10.1067/mpd.2002.123880
  2. Werlin SL, Kugathasan S, Frautschy BC. Pancreatitis in children. J Pediatr Gastroenterol Nutr 2003;37:591-5. https://doi.org/10.1097/00005176-200311000-00017
  3. Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Shackford SR, Champion HR, et al. Organ injury scaling. Surg Clin North Am 1995;75:293-303. https://doi.org/10.1016/S0039-6109(16)46589-8
  4. Stringer MD. Pancreatitis and pancreatic trauma. Semin Pediatr Surg 2005;14:239-46. https://doi.org/10.1053/j.sempedsurg.2005.06.007
  5. Mattix KD, Tataria M, Holmes J, Kristoffersen K, Brown R, Groner J, et al. Pediatric pancreatic trauma: predictors of nonoperative management failure and associated outcomes. J Pediatr Surg 2007;42:340-4. https://doi.org/10.1016/j.jpedsurg.2006.10.006
  6. Benifla M, Weizman Z. Acute pancreatitis in childhood analysis of literature data. J Clin Gastroenterol 2003; 37:100-2. https://doi.org/10.1097/00004836-200308000-00002
  7. Wood JH, Partrick DA, Bruny JL, Sauaia A, Moulton SL. Operative vs nonoperative management of blunt pancreatic trauma in children. J Pediatr Surg 2010;45:401-6. https://doi.org/10.1016/j.jpedsurg.2009.10.095
  8. Dryburgh PR, White JAM. Late obstruction of the intrahepatic common bile duct after seat-belt injury. S Afr Med J 1980;58:534-5.
  9. Choi BH, Lim YJ, Yoon CH, Kim EA, Park YS, Kim KM. Acute pancreatitis associated with biliary disease in children. J Gastroenterol Hepatol 2003;18:915-21. https://doi.org/10.1046/j.1440-1746.2003.03080.x
  10. Ko JS. Fibrosing pancreatitis causing obstructive jaundice. Korean J Gastroenterol 2008;52:271-2.
  11. Yachha SK, Chetri K, Saraswat VA, Baijal SS, Sikora SS, Lal R, et al. Management of childhood pancreatic disorders: a multidisciplinary approach. J Pediatr Gastroenterol Nutr 2003;36:206-12. https://doi.org/10.1097/00005176-200302000-00009
  12. Sylvester FA, Shucktt B, Cutz E, Durie PR, Marcon MA. Management of fibrosing pancreatitis in children presenting with obstructive jaundice. Gut 1998;43:715-20. https://doi.org/10.1136/gut.43.5.715
  13. Wales PW, Shuckett B, Kim PCW. Long-term outcome after nonoperative management of complete traumatic pancreatic transection in children. J Pediatr Surg 2001; 36:823-7. https://doi.org/10.1053/jpsu.2001.22970
  14. Delcenserie R, Joly JP, Lenne C, Kannoun MM, Sevestre H, Capron JP, et al. Fibrotic stricture of the extrapancreatic biliary tract: a new complication of acute pancreatitis. Two cases. Pancreas 1995;10:100-3. https://doi.org/10.1097/00006676-199501000-00014