[Clinical manifestation of acute pancreatitis in children with caustic ingestion injury - the role of oxidative stress].
For a 10 years period (1996-2005) 66 children with severe caustic injuries of the esophagus and stomach were admitted at the Department of Pediatric Surgery. Subject of this article are 17 children with clinical, laboratory and intraoperative proven acute pancreatitis. The patients were admitted at the clinic 12 hours to 12 days after the ingestion of the corrosive agent. Fifteen of them underwent surgery and different surgical procedures were performed - gastric resection, transhiatal esophagectomy, gastrectomy, gastrostomy. In all patients were found elevated levels of alpha-amilase in blood serum and urine as well as elevated CRP in blood serum. Clinically manifested acute pancreatitis was diagnosed on ultrasound studies and laparotomy. The newest theories about the genesis of acute pancreatitis emphasize on the role of oxidative stress. Experimental models suggest that burn trauma (thermal or chemical) cause critical increase of free oxygen radicals and lipid peroxydation products in the tissue of the damaged organ and the bloodstream. The local tissue damage leads to release of inflammatory mediators which enter the bloodstream and cause distant organs damage of - lung, liver, kidneys and pancreas. In this preliminary report the authors discuss the pathogenesis of acute pancreatitis in children with acute corrosive ingestion injury of the esophagus and stomach. We call this phenomenon " caustic " oxidative stress. This is the first scientific report on this topic in the reviewed literature.
Brankov
O
O
Department of Pediatric Surgery, Emergency Hospital N.I.Pirogov - Sofia, Bulgaria.
Shivachev
Kh
Kh
Drebov
R
R
Dumanov
K
K
D000208:Acute Disease; D002057:Burns, Chemical / Q000150:complications / Q000378:metabolism / Q000601:surgery; D002424:Caustics / Q000633:toxicity*; D002648:Child; D004947:Esophagus / Q000293:injuries* / Q000378:metabolism / Q000601:surgery; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D012189:Retrospective Studies; D013270:Stomach / Q000293:injuries* / Q000601:surgery; D000516:alpha-Amylases / Q000097:blood / Q000652:urine
D002424:Caustics; D000516:alpha-Amylases