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Ascariasis Associated with Acute Pancreatitis in a Child

兒童蛔蟲感染合併急性胰臟炎:一病例報告

摘要


本文報告一六歲原住民女童因腹痛由急診住院,澱粉酵素高達2976U/L,臨床症狀包括發燒、白血球過多、低血鈉、酸血症及單側肋膜積水。影像診斷包括腹部超音波與電腦斷層掃瞄,發現胰臟腫大。追問其病史,並無創傷、服藥、遺傅疾病以及瞻道結石等問題。住院第二天因在嘔吐物及糞便中發現蛔蟲與鞭蟲,而診斷爲疑似蛔蟲感染引起之急性胰臟炎。遂給予mebendazde,隨後共排出蛔蟲十四條與鞭蟲二十條。合併支持性療法病人恢復良好,於第九天出院。本文檢討其致病機轉,並檢索文獻提出診斷治療之適當方法。

並列摘要


A six-year-old aboriginal girl living in northeast Taiwan, was admitted via Emergency Service with the chief complaint of epigastralgia for one day. Fever, leucocytosis, hyponatremia, acidosis and unilateral pleural effusion were noted. The serum amylase was 2976 U/L. Image studies including abdominal sonography and computerized tomography revealed a swollen and edematous pancreas. There was no evidence of previous trauma, drug using, hereditary problems, nor biliary tract stone; the patient was noted to have adult worms and eggs of Ascaris lumbricoides in stool and vomitus. Ascariasis associated with pancreatitis was suspected. She recovered completely after antihelmintic therapy (mebendazole) and supportive treatment. Fourteen ascarides and 20 trichurides were expelled during nine days of admission.

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