RESUMO
Bicycle handlebar injuries are the commonest cause of pancreatic trauma in children and adolescents, especially in males. Recognition of such injuries and initiation of correct treatment may be delayed when there is no abdominal wall bruising. We present a case of a 6-year boy with severe pancreatic trauma, who was referred from a local hospital following bicycle handlebar injury five days earlier. Contrast-enhanced computed tomography showed grade III pancreatic injury, which was repaired the following day; and he subsequently made a good recovery. The case highlights challenges faced by non-specialist clinicians working in resource-limited settings in diagnosing these injuries. Key Words: Bicycle handlebar injury, Blunt trauma, Pancreatic injury.
Assuntos
Traumatismos Abdominais , Ferimentos não Penetrantes , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/etiologia , Traumatismos Abdominais/cirurgia , Adolescente , Ciclismo/lesões , Criança , Humanos , Masculino , Pâncreas/diagnóstico por imagem , Pâncreas/cirurgia , Estudos Retrospectivos , Ferimentos não Penetrantes/etiologia , Ferimentos não Penetrantes/cirurgiaRESUMO
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease. Childhood-onset SLE is extremely rare and comprises only 10% to 20% of all cases. In this case report, we present a 9-year-old boy from northeastern India who presented with fever, cough, vague abdominal pain, lethargy and swelling of face and legs. Initial impression was one of sepsis with central nervous system (CNS) involvement and was treated accordingly. Detailed clinical examination with subsequent laboratory and imaging studies clinched the diagnosis of SLE. The patient showed rapid resolution of symptoms with immunoglobulins, cyclophosphamide and steroid therapy. A brief discussion on childhood neuropsychiatric lupus syndrome and SLE with CNS infections is included here.
