title: Epigastric pain and sonographic assessment of the pancreas in dengue hemorrhagic fever.
abstract: OBJECTIVE
  This study reports the sonographic features of the pancreas in children who have dengue hemorrhagic fever (DHF) with epigastric pain, evaluates pancreatic abnormalities as the source of this pain, and relates sonographic findings, DHF status, and serum levels of amylase and lipase.
  
  
  METHODS
  Over 3.5 years, real-time sonographic examination of the pancreas was prospectively performed in 148 children (age range, 5 months-14 years) who had DHF with epigastric pain. The DHF diagnosis was confirmed by serologic examination and viral isolation.
  
  
  RESULTS
  Of the 142 children included in this study, 72 had mild DHF (grade I or II) and 70 had severe DHF (grade III or IV). An enlarged pancreas was found in 41 patients (29%), 10 (14%) of whom had mild DHF and 31 (44%) of whom had severe DHF. The pancreas was hyperechoic relative to the liver in 36 patients (25%), isoechoic in 98 (69%), and hypoechoic in 8 (6%).
  
  
  CONCLUSIONS
  The majority of patients with DHF and epigastric pain do not have an enlarged pancreas, different echogenicity of the pancreas compared with the liver, or a dilated pancreatic duct. Thus, pathologic changes of the pancreas cannot be the only cause of epigastric pain in DHF patients. Increased serum levels of amylase and lipase are commonly seen in patients with severe DHF and an enlarged pancreas.
authors.affiliation: Department of Pediatrics, Sumber Waras Hospital, Faculty of Medicine, Jakarta, Indonesia.
authors.forename: M W
authors.initials: MW
authors.lastname: Setiawan
authors.forename: T K
authors.initials: TK
authors.lastname: Samsi
authors.forename: H
authors.initials: H
authors.lastname: Wulur
authors.forename: D
authors.initials: D
authors.lastname: Sugianto
authors.forename: T N
authors.initials: TN
authors.lastname: Pool
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000681:Amylases / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008049:Lipase / Q000097:blood; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D019595:Severe Dengue / Q000150:complications / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D008049:Lipase; D000681:Amylases