Nutrition status and outcome in children with acute pancreatitis

Background: AP (Acute Pancreatitis) in children is being more and more diagnosed across the world and developing nation like India. This may be because of multiple factors like better health sector developments, change in dietary and social lifestyle changes due to fast improving economy. There are lots of unknown factors also leading to increase in incidence of AP in children in developing nations like India.Methods: Five-year retrospective data of AP patients admitted Paediatric Gastroenterology department extracted. Data of 63 children collected in five years from 2012 to 2016. Anthropometric data, feeding details, liver function test (LFT) data recorded. Anthropometric data analysed with IAP growth charts. Data entered in excel sheet of window 10. Appropriate statistical data used for analysis of variables.Results: Majority of children of AP were 11-15 years age group. In 63 patients, 28 (44.4%) were undernourished, 23 (36.5%) having normal BMI, 9 (14.3%) were overweight and 3 (4.8%) were obese. Nasojejunal feeding was associated mostly in patients with severe AP. LFT were deranged mostly in cases of severe AP.Conclusions: Overweight, obese and also undernourished children were having more severe AP. Children on nasojejunal feeding (NJ) were mostly having severe AP.

Functional Constipation In Children; Changing Clinical Spectrum With Unusual Presentation: A Case Report

Constipation in children is progressively increasing day by day because of changing lifestyle and dietary intake. Sometimes, functional constipation cases are misdiagnosed as functional abdominal pain because of inappropriate history and examination. We present an 8-years-old boy with a history of intermittent moderate to severe abdominal pain for 2 months. Basic blood investigations and ultrasound of the abdomen were normal, surprisingly, X-ray of the abdomen revealed the diagnosis.Simple X-ray erect abdomen is very useful in a special situation for the diagnosis of functional constipation.

Ruptured Sinus of a Valsalva Associated with Autosomal-Dominant Polycystic Kidney Disease in a young male

Autosomal-dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by localized cellular proliferation and extracellular matrix abnormalities resulting in both renal and extra renal manifestations, with multiple structural flaws such renal cysts, cerebral and aortic aneurysms, annulo-aortic ectasia, and valvular insufficiency states. Association between Autosomal-dominant polycystic kidney disease (ADPKD) and ruptured sinus of Valsalva aneurysm (SVA) has rarely been documented before. We herein report a case of Autosomal-dominant polycystic kidney disease (ADPKD) who presented with shortness of breath, was diagnosed as a case of ruptured sinus of Valsalva aneurysm (SVA) and defect was closed successfully.

Rapunzel Syndrome : A Rare Cause of Vomiting and Pain Abdomen.

Bezoar is an agglomeration of food or foreign material in intestinal tract. Contiguous extension of trichobezoar into the small bowel can lead to the Rapunzel syndrome. We present rare case of Rapunzel syndrome in 16 year old female who presented with recurrent vomiting.

Isolated tubercular liver abscess in children treated with percutaneous isoniazid infusion.

Isolated Tubercular liver abscess is mainly reported in adult patients. We report two cases of isolated tubercular liver abscess in paediatric patients. Diagnosis was made by clinical and ultrasound guided aspiration of pus showing acid fast bacilli in one case. In second case, biopsy of the abscess wall was confirmatory. In both cases percutaneous drainage of pus and transcatheter infusion of Isoniazid was given. After two weeks of infusion no acid fast bacilli was detected and cavity size decreased. Direct infusion of anti-tubercular drugs is more efficient than systemic therapy alone. This is first of its kind in treating isolated tubercular abscess in paediatric patients. So, percutaneous infusion of anti-tubercular agents can be considered in the treatment of tubercular liver abscess.