[Traumatic pancreatitis with peripheral osteolysis suggesting child abuse]

In a nine year old girl pancreatitis was suspected after roentgenologic demonstration of osteolytic lesions in the short bones of her hands and feet. Similar to the 18 cases found in the literature she had upper abdominal trauma in her history, and as in 6 other cases there was a history of child abuse and battering. There was complete remission of the lesions following operation of the pancreatic pseudocyst. In this disease pseudocysts develop very often, they were found in 12 of the 18 cases reported. There is no valid explanation of the pathogenetic mechanism leading to osteolytic lesions. Intracapillary coagulation might contribute to the development of necrotic areas in the bone. It is concluded that especially in patients with only slight upper abdominal pain roentgenologic examination of part of the skeleton might be helpful in establishing the diagnosis.