关键词: 胰腺炎, 诊断, 中西医结合治疗, 儿童, 胆总管囊肿

Abstract:

Objective To investigate the early diagnosis, integrated Chinese and Western medicine treatment and prevention of acute biliary pancreatitis (ABP) in children, and to improve the success rate of diagnosis and treatment. Methods A typical pediatric case of ABP was analyzed, and the diagnosis, differential diagnosis, auxiliary examination characteristics, early integrated Chinese and Western medicine treatment, and the choice of surgical methods were summarized. Results Acute pancreatitis (AP) in children was more commonly caused by viral infection than that of biliary factors. Misdiagnosis, missed diagnosis and mistreatment were prone to occur in children with AP. In adults, ABP was mainly caused by biliary stones; while in children, it was usually caused by congenital biliary dysplasia like congenital choledochal cyst. When certain factors like strenuous exercise led bile to reflux into the pancreatic duct, AP occurred. ABP in children was featured by a sudden onset, manifesting as early neurological symptoms like vomiting and lethargy, which was easy to be misdiagnosed as a neurological disease. Color Doppler ultrasound and abdominal computed tomography (CT) contributed to visualize abnormal imaging findings of pancreatic and congenital biliary cysts, which were common and reliable diagnostic tools of ABP in children. Early treatment of ABP in children with integrated Chinese and Western medicine treatment could reduce the incidence of complications and mortality, and an appropriate time of operation should be individually determined. Conclusion ABP in children has its own characteristics. Clinicians should improve the understanding of ABP. It is recommended to carry out imaging screening in children's health examination, aiming to find out congenital biliary malformations, and to carry out corresponding treatment interventions as early as possible, which can effectively prevent the occurrence of ABP.

Key words: pancreatitis, diagnosis, integrated Chinese and Western medicine treatment, children, choledochal cyst