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Continuous regional arterial infusion effective for children with acute necrotizing pancreatitis even under neutropenia
Author(s) -
Fukushima Hiroko,
Fukushima Takashi,
Suzuki Ryoko,
Enokizono Takashi,
Matsunaga Maki,
Nakao Tomohei,
Koike Kazutoshi,
Mori Kensaku,
Matsueda Kiyoshi,
Sumazaki Ryo
Publication year - 2013
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2012.03702.x
Subject(s) - medicine , acute pancreatitis , pancreatitis , neutropenia , febrile neutropenia , antibiotics , intensive care medicine , chemotherapy , anesthesia , surgery , microbiology and biotechnology , biology
Severe acute pancreatitis is one of the critical conditions that may develop in children with cancer. The leading cause of death due to acute pancreatitis is infectious pancreatitis or circulation collapse. Therefore, patients who develop acute pancreatitis while undergoing chemotherapy or after hematopoietic transplantation are at risk for a life‐threatening and fatal course. We treated 140 patients with malignancy from April 2002 to March 2009 at our hospital and encountered 3 patients under neutropenia who developed severe acute pancreatitis. Two of them were successfully treated with continuous regional arterial infusion of a protease inhibitor and antibiotic even under agranulocytosis. Another patient was treated with conventional therapy with intravenous antibiotics plus a protease inhibitor and total or partial parenteral nutrition. Even though the two patients treated with continuous regional arterial infusion presented much more severe conditions, their symptoms resolved earlier. In conclusion, acute pancreatitis is one of the severe complications of childhood malignancy. Even under agranulocytosis, continuous regional arterial infusion of a protease inhibitor and antibiotic was well tolerated and effective among our cases and might reduce early death due to pancreatitis.