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CardioVascular and Interventional Radiology

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01-05-2009 | Case Report

Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

Authors: Motoo Nakagawa, Hiroyuki Ogino, Masashi Shimohira, Masaki Hara, Yuta Shibamoto

Published in: CardioVascular and Interventional Radiology | Issue 3/2009

Abstract

A case of acute necrotizing pancreatitis due to Mycoplasma pneumoniae infection was treated in an 8-year-old girl. She experienced acute pancreatitis during treatment for M. pneumoniae. Contrast-enhanced computed tomographic scan revealed necrotizing pancreatitis. The computed tomographic severity index was 8 points (grade E). A protease inhibitor, ulinastatin, was provided via intravenous infusion but was ineffective. Continuous regional arterial infusion therapy was provided with gabexate mesilate (FOY-007, a protease inhibitor) and meropenem trihydrate, and the pancreatitis improved. This case suggests that infusion therapy is safe and useful in treating necrotizing pancreatitis in children.

Takeda K, Matsuno S, Sunamura M et al (1996) Continuous regional arterial infusion of protease inhibitor and antibiotics in acute necrotizing pancreatitis. Am J Surg 171:394–398PubMedCrossRef

Takagi K, Isaji S (2000) Therapeutic efficacy of continuous arterial infusion of an antibiotic and a protease inhibitor via the superior mesenteric artery for acute pancreatitis in an animal model. Pancreas 21:279–289PubMedCrossRef

Takeda K, Matsuno S, Ogawa M et al (2001) Continuous regional arterial infusion (CRAI) therapy reduces the mortality rate of acute necrotizing pancreatitis: results of a cooperative survey in Japan. J Hepatobiliary Pancreat Surg 8:216–220PubMedCrossRef

Takeda K, Yamauchi J, Shibuya K et al (2001) Benefit of continuous regional arterial infusion of protease inhibitor and antibiotic in the management of acute necrotizing pancreatitis. Pancreatology 1:668–673

Imaizumi H, Kida M, Nishimaki H et al (2004) Efficacy of continuous regional arterial infusion of a protease inhibitor and antibiotic for severe acute pancreatitis in patients admitted to an intensive care unit. Pancreas 28:369–373PubMedCrossRef

Satoh H, Harada M, Tashiro S et al (2004) The effect of continuous arterial infusion of gabexate mesilate (FOY-007) on experimental acute pancreatitis. J Med Invest 51:186–193PubMedCrossRef

Mikami Y, Takeda K, Omura N et al (2005) New strategy for acute necrotizing pancreatitis: continuous regional arterial infusion (CRAI) therapy. Rocz Akad Med Bialymst 50:101–105PubMed

Takeda K (2007) Antiproteases in the treatment of acute necrotizing pancreatitis: continuous regional arterial infusion. JOP 8(4 suppl):526–532PubMed

Yasuda T, Ueda T, Takeyama Y et al (2007) Treatment strategy against infection: clinical outcome of continuous regional arterial infusion, enteral nutrition, and surgery in severe acute pancreatitis. J Gastroenterol 42:681–689PubMedCrossRef

10.

Piascik M, Rydzewska G, Milewski J et al (2008) Results of a randomized controlled trial of continuous regional arterial infusion (CRAI) of proteinase inhibitor and antibiotic in severe acute pancreatitis (SAP). Pancreatology 8:344

11.

Benifla M, Weizman Z (2003) Acute pancreatitis in childhood: analysis of literature data. J Clin Gastroenterol 37:169–172PubMedCrossRef

12.

Werlin SL (2007) Pancreatitis. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds) Nelsontextbook of pediatrics, 18th edn. Elsevier, Philadelphia, pp 1653–1657

13.

Morimoto A, Imamura T, Ishii R et al (2008) Successful management of severe l-asparaginase-associated pancreatitis by continuous regional arterial infusion of protease inhibitor and antibiotic. Cancer 25:1362–1369CrossRef

14.

Abukawa D (2006) Pancreatitis. In: Ohzeki T, Furukawa S, Yokota S (eds) Today's therapy in pediatrics (in Japanese), 14th edn. Igakushoin, Tokyo, p 362

15.

Knaus WA, Draper EA, Wagner DP et al (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829PubMedCrossRef

16.

Dervenis C, Johnson CD, Bassi C et al (1999) Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference. Int J Pancreatol 25:195–210PubMed

17.

Takeda K, Takada T, Kawarada Y et al (2006) JPN guidelines for the management of acute pancreatitis: medical management of acute pancreatitis. J Hepatobiliary Pancreat Surg 13:42–47PubMedCrossRef

18.

DeBanto JR, Goday PS, Pedroso MR et al (2002) Acute pancreatitis in children. Am J Gastroenterol 97:1726–1731PubMedCrossRef

19.

Balthazar EJ, Robinson DL, Megibow AJ et al (1990) Acute pancreatitis: value of CT in establishing prognosis. Radiology 174:331–336PubMed

20.

Manes G, Rabitti PG, Menchise A et al (2003) Prophylaxis with meropenem of septic complications in acute pancreatitis: a randomized, controlled trial versus imipenem. Pancreas 27:e79–e83PubMedCrossRef

21.

Shirai K, Tanjou K, Shinohara K et al (2008) The effectiveness of continuous regional arterial infusion therapy with meropenem in severe acute pancreatitis compared with imipenem: a prospective randomized study. Jpn J Gastroenterol Surg 41:1–11

22.

Freeman R, McMahon MJ (1978) Acute pancreatitis and serological evidence of infection with Mycoplasma pneumoniae. Gut 19:367–370PubMedCrossRef

23.

al-Abassi A (2002) Acute pancreatitis associated with Mycoplasma pneumoniae: a case report of missed diagnosis. Med Princ Pract 11:112–115PubMedCrossRef

24.

Golzarian J, Nicaise N, Deviere J (1997) Transcatheter embolization of pseudoaneurysms complicating pancreatitis. Cardiovasc Intervent Radiol 20:435–440PubMedCrossRef

25.

Kirby JM, Vora P, Midia M, Rawlinson J (2008) Vascular complications of pancreatitis: imaging and intervention. Cardiovasc Intervent Radiol 31:957–970PubMedCrossRef

26.

Nouira K, Bedioui H, Azaiez O et al (2007) Percutaneous drainage of suppurative pylephlebitis complicating acute pancreatitis. Cardiovasc Intervent Radiol 30:1242–1244PubMedCrossRef

27.

Inoue K, Hirota M, Kimura Y et al (2003) Further evidence for endothelin as an important mediator of pancreatic and intestinal ischemia in severe acute pancreatitis. Pancreas 26:218–223PubMedCrossRef

28.

Takeda K, Mikami Y, Fukuyama S et al (2005) Pancreatic ischemia associated with vasospasm in the early phase of human acute necrotizing pancreatitis. Pancreas 30:40–49PubMedCrossRef

29.

Yuasa T, Taniguchi Y, Yamada E, Inachi S, Shimizu M (1997) Severe cutaneous and venous damage after DIC therapy. J Dermatol 24:466–470PubMed

30.

Tsujino T, Kawabe T, Omata M (2007) Antiproteases in preventing post-ERCP acute pancreatitis. JOP 8:509–517PubMed

31.

Nishijima MK, Takezawa J, Taenaka N et al (1983) Application of HPLC measurement of plasma concentration of gabexate mesilate. Thromb Res 31:279–284PubMedCrossRef

Title: Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child
Authors: Motoo Nakagawa
Hiroyuki Ogino
Masashi Shimohira
Masaki Hara
Yuta Shibamoto
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: CardioVascular and Interventional Radiology / Issue 3/2009
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-008-9457-7

At a glance: The STEP trials

Springer Medicine

Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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