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Acute Hemorrhagic Pancreatitis: Electrolyte and Electrocardiographic Changes

Acute Hemorrhagic Pancreatitis: Electrolyte and Electrocardiographic Changes Abstract Acute hemorrhagic pancreatitis is a well known clinical entity,1-3 but rare in the pediatric age group. The signs and symptoms are nonspecific and resemble those found in many common systemic and abdominal diseases.3 This illness is characterized by increased serum and urinary amylase and hyperglycemia; however, serum amylase is increased in only about 65% of cases,4 and either hyper- or hypoglycemia may occur.3,5 In adults, severe electrolyte disturbances and various associated electrocardiographic changes have been described.6-8 This is a report of a 10-year-old girl with acute hemorrhagic pancreatitis associated with severe persistent electrolyte disturbances and electrocardiographic changes. Since Edmonson and Berne9 emphasized the significance of hypocalcemia accompanying pancreatitis, the serum calcium level has been a point of special interest in adults.10 Among 75 cases of acute and chronic pancreatitis reported in the pediatric literature since 1944,1,2,5,11-26 in only 11 were calcium levels References 1. Hendren, W.H.; Greep, J.M.; and Patton, A.S.: Pancreatitis in Childhood: Experience With 15 Cases , Arch Dis Child 40: 132-145 ( (April) ) 1965.Crossref 2. Sticker, G.B., and Yomemoto, R.H.: Acute Pancreatitis in Children , Amer J Dis Child 95:206-213 ( (Feb) ) 1958. 3. White, T.T.: Pancreatitis , Baltimore: Williams & Wilkins Co., 1966, pp 83-110. 4. O'Brien, J.J.: Pancreatitis: Observations of 131 Patients , New Eng J Med 253: 355-360 ( (Sept 1) ) 1955.Crossref 5. Laraya-Cuasay, L.R.; Wolfe, R.; and Hughes, W.T.: Acute Pancreatitis and Hypoglycemia , Clin Pediat 7:525-528 ( (Sept) ) 1968.Crossref 6. Bauerlein, T.C., and Stobbe, L.H.O.: Acute Pancreatitis Simulating Myocardial Infarction With Characteristic Electro-cardiographic Changes , Gastroenterology 27:861-864 ( (Dec) ) 1954. 7. Shallenberger, P.L., and Kapp, P.F.: Acute Pancreatitis: A Clinical Review of 72 Attacks Occurring in 54 Patients , Ann Intern Med 48:1185-1193 ( (June) ) 1958.Crossref 8. Blumenthal, H.T.; Probstein, J.B.; and Zollinger, R.M.: Pancreatitis , Springfield, Ill.: Charles C Thomas, Publishers, 1959, p 146-150, 277-279. 9. Edmonson, H.A., and Berne, C.J.: Calcium Changes in Acute Pancreatic Necrosis , Surg Gynec Obstet 79:240-244 ( (Sept) ) 1944. 10. Lillijekvist, R.E.: Hypocalcemia and the Diagnosis of Acute Pancreatitis , Acta Chir Scand 115:433-446 ( (Nov) , pt 6) 1958. 11. Warwick, W.J., and Leavitt, S.R.: Chronic Relapsing Pancreatitis in Childhood , Amer J Dis Child 99:648-652 ( (Nov) ) 1960. 12. Frey, C., and Redo, S.F.: Inflammatory Lesions of the Pancreas in Infancy and Childhood , Pediatrics 32:93-102 ( (July) ) 1963. 13. Blumenstock, D.A.; Mithoefer, J.; and Santulli, T.V.: Acute Pancreatitis in Children , Pediatrics 19:1002-1010 ( (Aug) ) 1957. 14. Gibson, L.E., and Haller, J.A.: Acute Pancreatitis Associated With Congenital Cyst of the Common Bile Duct , J Pediat 55:650-657 ( (Nov) ) 1959.Crossref 15. Gibson, J.M., and Gibson, J.M.: Acute Hemorrhagic Pancreatitis in Childhood , J Pediat 48:486-488 ( (April) ) 1956.Crossref 16. Collins, J.: Pancreatitis in Young Children , Arch Dis Child 33:432-436 ( (Oct) ) 1958.Crossref 17. Blumenthal, H.T., and Probstein, J.B.: Acute Pancreatitis in the Newborn, in Infancy and in Childhood , Amer Surg 27:533-539 ( (July) ) 1961. 18. Pender, B.W.: Acute Pancreatitis in a Child Aged 3 Years , Lancet 1:409-410 ( (Feb 16) ) 1957.Crossref 19. Baar, H.S., and Wolff, O.H.: Pancreatic Necrosis in Cortisone-Treated Children , Lancet 1:812-815 ( (April 13) ) 1957.Crossref 20. Mithoefer, J.: Pseudocyst of the Pancreas in Childhood , Pediatrics 8:534-541 ( (Oct) ) 1951. 21. Shallow, T.A., and Wagner, F.B.: Traumatic Pancreatitis , Ann Surg 125:66-71 ( (Jan) ) 1947.Crossref 22. Duncan, N.A.: Pancreatitis Due to Ascaris , Brit Med J 1:905 ( (May 8) ) 1948.Crossref 23. Levitzky, E.; Lance, E.; and Armstrong, L.: Pseudocysts of the Pancreas in Childhood , Amer J Dis Child 92:60-62 ( (July) ) 1956. 24. Haigh, E.: Acute Pancreatitis in Childhood , Arch Dis Child 31:273-275 ( (Aug) ) 1956.Crossref 25. Boss, G.: Acute or Chronic Pancreatitis in a Boy of Six , Med Press 234: 398-400 ( (Oct 26) ) 1955. 26. Stein, D.S.: Pancreatitis: Acute and Relapsing in Infancy and Childhood , S Afr Med J 37:1066-1072 ( (Oct 19) ) 1963. 27. Leistyna, J.A., and Macaulay, J.C.: Traumatic Pancreatitis in Childhood: Report of a Case and Review of the Literature , Amer J Dis Child 107:644-648 ( (June) ) 1964.Crossref 28. Bockus, H.L., et al: Clinical Features of Acute Inflammation of the Pancreas , Arch Intern Med 96:308-321 ( (Sept) ) 1955.Crossref 29. Comfort, M.W.; Ganhill, E.E.; and Baggenstoss, H.H.: Chronic Relapsing Pancreatitis: A Study of 29 Cases Without Associated Disease of the Biliary or Gastrointestinal Tract , Gastroenterology 6: 239-285 ( (April) ) and 376-408 (May) 1946. 30. Becker, W.F.: Traumatic Pancreatitis , Amer Surg 20:525-532 ( (May) ) 1959. 31. Turner-Warwick, R.T.: Hypocalcemia in Acute Pancreatitis , Lancet 2: 546-547 ( (Sept 15) ) 1956.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Acute Hemorrhagic Pancreatitis: Electrolyte and Electrocardiographic Changes

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Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1970.02100050145011
Publisher site
See Article on Publisher Site

Abstract

Abstract Acute hemorrhagic pancreatitis is a well known clinical entity,1-3 but rare in the pediatric age group. The signs and symptoms are nonspecific and resemble those found in many common systemic and abdominal diseases.3 This illness is characterized by increased serum and urinary amylase and hyperglycemia; however, serum amylase is increased in only about 65% of cases,4 and either hyper- or hypoglycemia may occur.3,5 In adults, severe electrolyte disturbances and various associated electrocardiographic changes have been described.6-8 This is a report of a 10-year-old girl with acute hemorrhagic pancreatitis associated with severe persistent electrolyte disturbances and electrocardiographic changes. Since Edmonson and Berne9 emphasized the significance of hypocalcemia accompanying pancreatitis, the serum calcium level has been a point of special interest in adults.10 Among 75 cases of acute and chronic pancreatitis reported in the pediatric literature since 1944,1,2,5,11-26 in only 11 were calcium levels References 1. Hendren, W.H.; Greep, J.M.; and Patton, A.S.: Pancreatitis in Childhood: Experience With 15 Cases , Arch Dis Child 40: 132-145 ( (April) ) 1965.Crossref 2. Sticker, G.B., and Yomemoto, R.H.: Acute Pancreatitis in Children , Amer J Dis Child 95:206-213 ( (Feb) ) 1958. 3. White, T.T.: Pancreatitis , Baltimore: Williams & Wilkins Co., 1966, pp 83-110. 4. O'Brien, J.J.: Pancreatitis: Observations of 131 Patients , New Eng J Med 253: 355-360 ( (Sept 1) ) 1955.Crossref 5. Laraya-Cuasay, L.R.; Wolfe, R.; and Hughes, W.T.: Acute Pancreatitis and Hypoglycemia , Clin Pediat 7:525-528 ( (Sept) ) 1968.Crossref 6. Bauerlein, T.C., and Stobbe, L.H.O.: Acute Pancreatitis Simulating Myocardial Infarction With Characteristic Electro-cardiographic Changes , Gastroenterology 27:861-864 ( (Dec) ) 1954. 7. Shallenberger, P.L., and Kapp, P.F.: Acute Pancreatitis: A Clinical Review of 72 Attacks Occurring in 54 Patients , Ann Intern Med 48:1185-1193 ( (June) ) 1958.Crossref 8. Blumenthal, H.T.; Probstein, J.B.; and Zollinger, R.M.: Pancreatitis , Springfield, Ill.: Charles C Thomas, Publishers, 1959, p 146-150, 277-279. 9. Edmonson, H.A., and Berne, C.J.: Calcium Changes in Acute Pancreatic Necrosis , Surg Gynec Obstet 79:240-244 ( (Sept) ) 1944. 10. Lillijekvist, R.E.: Hypocalcemia and the Diagnosis of Acute Pancreatitis , Acta Chir Scand 115:433-446 ( (Nov) , pt 6) 1958. 11. Warwick, W.J., and Leavitt, S.R.: Chronic Relapsing Pancreatitis in Childhood , Amer J Dis Child 99:648-652 ( (Nov) ) 1960. 12. Frey, C., and Redo, S.F.: Inflammatory Lesions of the Pancreas in Infancy and Childhood , Pediatrics 32:93-102 ( (July) ) 1963. 13. Blumenstock, D.A.; Mithoefer, J.; and Santulli, T.V.: Acute Pancreatitis in Children , Pediatrics 19:1002-1010 ( (Aug) ) 1957. 14. Gibson, L.E., and Haller, J.A.: Acute Pancreatitis Associated With Congenital Cyst of the Common Bile Duct , J Pediat 55:650-657 ( (Nov) ) 1959.Crossref 15. Gibson, J.M., and Gibson, J.M.: Acute Hemorrhagic Pancreatitis in Childhood , J Pediat 48:486-488 ( (April) ) 1956.Crossref 16. Collins, J.: Pancreatitis in Young Children , Arch Dis Child 33:432-436 ( (Oct) ) 1958.Crossref 17. Blumenthal, H.T., and Probstein, J.B.: Acute Pancreatitis in the Newborn, in Infancy and in Childhood , Amer Surg 27:533-539 ( (July) ) 1961. 18. Pender, B.W.: Acute Pancreatitis in a Child Aged 3 Years , Lancet 1:409-410 ( (Feb 16) ) 1957.Crossref 19. Baar, H.S., and Wolff, O.H.: Pancreatic Necrosis in Cortisone-Treated Children , Lancet 1:812-815 ( (April 13) ) 1957.Crossref 20. Mithoefer, J.: Pseudocyst of the Pancreas in Childhood , Pediatrics 8:534-541 ( (Oct) ) 1951. 21. Shallow, T.A., and Wagner, F.B.: Traumatic Pancreatitis , Ann Surg 125:66-71 ( (Jan) ) 1947.Crossref 22. Duncan, N.A.: Pancreatitis Due to Ascaris , Brit Med J 1:905 ( (May 8) ) 1948.Crossref 23. Levitzky, E.; Lance, E.; and Armstrong, L.: Pseudocysts of the Pancreas in Childhood , Amer J Dis Child 92:60-62 ( (July) ) 1956. 24. Haigh, E.: Acute Pancreatitis in Childhood , Arch Dis Child 31:273-275 ( (Aug) ) 1956.Crossref 25. Boss, G.: Acute or Chronic Pancreatitis in a Boy of Six , Med Press 234: 398-400 ( (Oct 26) ) 1955. 26. Stein, D.S.: Pancreatitis: Acute and Relapsing in Infancy and Childhood , S Afr Med J 37:1066-1072 ( (Oct 19) ) 1963. 27. Leistyna, J.A., and Macaulay, J.C.: Traumatic Pancreatitis in Childhood: Report of a Case and Review of the Literature , Amer J Dis Child 107:644-648 ( (June) ) 1964.Crossref 28. Bockus, H.L., et al: Clinical Features of Acute Inflammation of the Pancreas , Arch Intern Med 96:308-321 ( (Sept) ) 1955.Crossref 29. Comfort, M.W.; Ganhill, E.E.; and Baggenstoss, H.H.: Chronic Relapsing Pancreatitis: A Study of 29 Cases Without Associated Disease of the Biliary or Gastrointestinal Tract , Gastroenterology 6: 239-285 ( (April) ) and 376-408 (May) 1946. 30. Becker, W.F.: Traumatic Pancreatitis , Amer Surg 20:525-532 ( (May) ) 1959. 31. Turner-Warwick, R.T.: Hypocalcemia in Acute Pancreatitis , Lancet 2: 546-547 ( (Sept 15) ) 1956.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Feb 1, 1970

References