Pancreatic ascites in childhood

Area of Science:

• Gastroenterology and Hepatology
• Pediatric Surgery

Background:

• Pancreatic ascites is a rare complication of pancreatitis, particularly in pediatric cases.
• Pancreatic duct stones and duct rupture are significant contributors to severe pancreatitis.
• Erythema ab igne is a cutaneous sign associated with chronic heat exposure, but its link to severe abdominal pain warrants investigation.

Observation:

• A 14-year-old girl presented with symptoms indicative of severe abdominal pain.
• Physical examination revealed abdominal erythema ab igne, a sign not typically associated with internal abdominal pathology.
• Imaging and clinical evaluation confirmed acute and chronic pancreatitis with associated pancreatic duct stones and a ruptured pancreatic duct.

Findings:

• The patient was diagnosed with pancreatic ascites secondary to complicated pancreatitis.
• Pancreatic duct stones and a ruptured pancreatic duct were identified as the underlying causes.
• Abdominal erythema ab igne was noted and considered a significant indicator of the patient's severe abdominal pain.

Implications:

• This case highlights the importance of considering rare causes of pancreatic ascites in adolescents.
• The presence of pancreatic duct stones and duct rupture necessitates aggressive management strategies.
• The association of erythema ab igne with severe abdominal pain in this context suggests its potential utility as a diagnostic clue in specific pediatric cases.