蛋白分解酵素阻害剤+抗生物質持続動注療法および後腹膜ドレナージ術にて救命しえた小児重症急性膵炎の1例

DOI Web Site 参考文献10件
  • 坂田 直昭
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 渋谷 和彦
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 阿部 忠義
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 三上 幸夫
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 元井 冬彦
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 山内 淳一郎
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 砂村 眞琴
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 武田 和憲
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine
  • 松野 正紀
    Department of Surgery, Devision of Gastroenterological Surgery, Tohoku University, Graduate School of Medicine

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タイトル別名
  • 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

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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.

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