A sudden death after the complaint of constipation - Not to overlook paediatric acute haemorrhagic pancreatitis

Research output: Contribution to journalArticle

Abstract

Introduction: Pancreatitis, an inflammatory condition of the pancreas, is rarely recognized in the paediatric age group and frequently be ignored in the clinical setting. Pancreatitis in children can be subdivided into acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis1. It is uncommon in paediatric age group compared to adult. Although acute pancreatitis is a rare condition in children, it shouldn't be overlooked as one of the differential diagnosis for acute abdomen by the attending clinician Case report: We hereby report a case of acute pancreatitis in a 4-year-old boy who presented with abdominal discomfort and constipation to Emergency Department. Unfortunately, proper diagnosis was not done upon initial presentation to the hospital and patient was discharged from the Emergency Department. Subsequently, patient collapsed and died at home about 12 hours after discharging from hospital. He was then brought to our centre by police officer for post-mortem examination to determine the cause of death. Results: Post mortem examination was performed and noted to have there were multiple foci of yellowish nodules deposition over the bilateral parietal pleural membrane, pericardium and greater omentum. The omental bursa was inflamed and haemorrhagic. The pancreas weighed 200 g with haemorrhagic and necrotic changes of the surface and parenchyma of the whole pancreas with some spared healthy area at the head of pancreases. Histology of the pancreases showed extensive necrosis with area of viable tissue containing neutrophils and extra-vasated red blood cells, the ruptured vessel wall and haemorrhagic necrosis of adipose tissue. The liver showed generalised macro and micro steatosis. Conclusion: To the best of our knowledge, this is the first case of post-mortem diagnosis of acute haemorrhagic pancreatitis in paediatric age group reported in Malaysia.

Original languageEnglish
Pages (from-to)263-265
Number of pages3
JournalInternational Medical Journal
Volume25
Issue number4
Publication statusPublished - 1 Aug 2018

Fingerprint

Constipation
Sudden Death
Pancreatitis
Pancreas
Pediatrics
Age Groups
Hospital Emergency Service
Autopsy
Necrosis
Acute Abdomen
Omentum
Pericardium
Malaysia
Peritoneal Cavity
Chronic Pancreatitis
Police
Adipose Tissue
Cause of Death
Histology
Neutrophils

Keywords

  • Acute abdomen
  • Acute haemorrhagic pancreatitis
  • Constipation
  • Forensic
  • Sudden death

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "A sudden death after the complaint of constipation - Not to overlook paediatric acute haemorrhagic pancreatitis",
abstract = "Introduction: Pancreatitis, an inflammatory condition of the pancreas, is rarely recognized in the paediatric age group and frequently be ignored in the clinical setting. Pancreatitis in children can be subdivided into acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis1. It is uncommon in paediatric age group compared to adult. Although acute pancreatitis is a rare condition in children, it shouldn't be overlooked as one of the differential diagnosis for acute abdomen by the attending clinician Case report: We hereby report a case of acute pancreatitis in a 4-year-old boy who presented with abdominal discomfort and constipation to Emergency Department. Unfortunately, proper diagnosis was not done upon initial presentation to the hospital and patient was discharged from the Emergency Department. Subsequently, patient collapsed and died at home about 12 hours after discharging from hospital. He was then brought to our centre by police officer for post-mortem examination to determine the cause of death. Results: Post mortem examination was performed and noted to have there were multiple foci of yellowish nodules deposition over the bilateral parietal pleural membrane, pericardium and greater omentum. The omental bursa was inflamed and haemorrhagic. The pancreas weighed 200 g with haemorrhagic and necrotic changes of the surface and parenchyma of the whole pancreas with some spared healthy area at the head of pancreases. Histology of the pancreases showed extensive necrosis with area of viable tissue containing neutrophils and extra-vasated red blood cells, the ruptured vessel wall and haemorrhagic necrosis of adipose tissue. The liver showed generalised macro and micro steatosis. Conclusion: To the best of our knowledge, this is the first case of post-mortem diagnosis of acute haemorrhagic pancreatitis in paediatric age group reported in Malaysia.",
keywords = "Acute abdomen, Acute haemorrhagic pancreatitis, Constipation, Forensic, Sudden death",
author = "{Mohd Swarhib}, {Shafee @ Aung Thu Ya} and {Mohd. Nor}, Faridah and Tan, {L. J.} and Tan, {R. Z.}",
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T1 - A sudden death after the complaint of constipation - Not to overlook paediatric acute haemorrhagic pancreatitis

AU - Mohd Swarhib, Shafee @ Aung Thu Ya

AU - Mohd. Nor, Faridah

AU - Tan, L. J.

AU - Tan, R. Z.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Introduction: Pancreatitis, an inflammatory condition of the pancreas, is rarely recognized in the paediatric age group and frequently be ignored in the clinical setting. Pancreatitis in children can be subdivided into acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis1. It is uncommon in paediatric age group compared to adult. Although acute pancreatitis is a rare condition in children, it shouldn't be overlooked as one of the differential diagnosis for acute abdomen by the attending clinician Case report: We hereby report a case of acute pancreatitis in a 4-year-old boy who presented with abdominal discomfort and constipation to Emergency Department. Unfortunately, proper diagnosis was not done upon initial presentation to the hospital and patient was discharged from the Emergency Department. Subsequently, patient collapsed and died at home about 12 hours after discharging from hospital. He was then brought to our centre by police officer for post-mortem examination to determine the cause of death. Results: Post mortem examination was performed and noted to have there were multiple foci of yellowish nodules deposition over the bilateral parietal pleural membrane, pericardium and greater omentum. The omental bursa was inflamed and haemorrhagic. The pancreas weighed 200 g with haemorrhagic and necrotic changes of the surface and parenchyma of the whole pancreas with some spared healthy area at the head of pancreases. Histology of the pancreases showed extensive necrosis with area of viable tissue containing neutrophils and extra-vasated red blood cells, the ruptured vessel wall and haemorrhagic necrosis of adipose tissue. The liver showed generalised macro and micro steatosis. Conclusion: To the best of our knowledge, this is the first case of post-mortem diagnosis of acute haemorrhagic pancreatitis in paediatric age group reported in Malaysia.

AB - Introduction: Pancreatitis, an inflammatory condition of the pancreas, is rarely recognized in the paediatric age group and frequently be ignored in the clinical setting. Pancreatitis in children can be subdivided into acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis1. It is uncommon in paediatric age group compared to adult. Although acute pancreatitis is a rare condition in children, it shouldn't be overlooked as one of the differential diagnosis for acute abdomen by the attending clinician Case report: We hereby report a case of acute pancreatitis in a 4-year-old boy who presented with abdominal discomfort and constipation to Emergency Department. Unfortunately, proper diagnosis was not done upon initial presentation to the hospital and patient was discharged from the Emergency Department. Subsequently, patient collapsed and died at home about 12 hours after discharging from hospital. He was then brought to our centre by police officer for post-mortem examination to determine the cause of death. Results: Post mortem examination was performed and noted to have there were multiple foci of yellowish nodules deposition over the bilateral parietal pleural membrane, pericardium and greater omentum. The omental bursa was inflamed and haemorrhagic. The pancreas weighed 200 g with haemorrhagic and necrotic changes of the surface and parenchyma of the whole pancreas with some spared healthy area at the head of pancreases. Histology of the pancreases showed extensive necrosis with area of viable tissue containing neutrophils and extra-vasated red blood cells, the ruptured vessel wall and haemorrhagic necrosis of adipose tissue. The liver showed generalised macro and micro steatosis. Conclusion: To the best of our knowledge, this is the first case of post-mortem diagnosis of acute haemorrhagic pancreatitis in paediatric age group reported in Malaysia.

KW - Acute abdomen

KW - Acute haemorrhagic pancreatitis

KW - Constipation

KW - Forensic

KW - Sudden death

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