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Acute Terminal Ileitis in Children: A Retrospective Study in a Pediatric Emergency Department
Miguel Angel Molina Gutiérrez1, Eva Martínez-Ojinaga Nodal2, Julia Piñán Díez3
1From the Pediatric Emergency Department.
Insights
Acute ileitis is a rare, benign cause of pediatric abdominal pain. This study found no association with inflammatory bowel disease (IBD) in children, differentiating it from adult cases.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Infectious Disease
Background:
- Acute ileitis is an uncommon condition presenting with abdominal pain in children.
- Distinguishing ileitis from other causes of abdominal pain, such as appendicitis, is crucial in the pediatric emergency setting.
Purpose of the Study:
- To describe the clinical presentation and outcomes of pediatric patients diagnosed with acute ileitis.
- To evaluate the association between acute ileitis and the development of inflammatory bowel disease (IBD) in children.
Main Methods:
- Retrospective study of pediatric patients diagnosed with terminal ileitis via abdominal ultrasonography between 2013-2014.
- Exclusion of patients with pre-existing inflammatory bowel disease (IBD).
- Collection of clinical, radiological, and laboratory data; assessment of hospitalization and outpatient follow-up.
Main Results:
- Twenty cases of acute ileitis were identified, all presenting with abdominal pain, often in the right lower quadrant.
- Elevated leukocyte count, C-reactive protein, and fibrinogen levels were observed; hemoglobin and platelet counts were normal.
- Microbial causes were identified in 3 cases (Yersinia enterocolitica, Campylobacter jejuni, Adenovirus); no cases of IBD were diagnosed.
Conclusions:
- Acute ileitis is a rare, benign condition in the pediatric emergency department, primarily managed by ruling out surgical emergencies.
- Unlike in adults, acute ileitis in children does not appear to be associated with the subsequent development of inflammatory bowel disease (IBD).
Objectives:
This study aims to describe the clinical presentation and outcome of patients diagnosed with acute ileitis in our pediatric emergency department.
Methods:
We performed a retrospective study of all patients diagnosed with terminal ileitis by abdominal ultrasonography findings in our pediatric emergency department, over the years 2013 and 2014. Patients with previous diagnosis of inflammatory bowel disease (IBD) were excluded. Data collected were clinical, radiological, and laboratory data at diagnosis; outcome including hospitalization care; and outpatient follow-up in pediatric gastroenterology and/or primary care.
Results:
A total of 20 cases were retrieved and studied. All of them presented with abdominal pain, 65% located in the right lower quadrant. Leukocyte count, C-reactive protein, and fibrinogen levels (means, 12,889; 4/μL; 50.1 mg/L; and 575 mg/dL, respectively) were above normal range. Hemoglobin and platelet count were normal. A microbial cause of ileitis was found in 3 cases (Yersinia enterocolitica, Campylobacter jejuni, and Adenovirus). Nine patients were referred to a pediatric gastroenterology unit. No cases of IBD were found.
Conclusions:
Acute ileitis is a rare and benign cause of abdominal pain in the pediatric emergency department. The main intervention on initial assessment is to rule out potentially severe causes of abdominal pain that could benefit of an emergency surgical procedure. In contrast with adults and adolescents, acute ileitis in children does not have a clear association with development of IBD.
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