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

Abstract

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.