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Saving the patient ​with rare severe hemorrhagic necrotizing pancreatitis

TTH.VN - In the evening of September 27, Hue Central Hospital announced that a pediatric patient suffering from pancreatitis leading to abdominal hemorrhage has been discharged after more than a month of intensive treatment by the medical staff.

Saving a 4 years-old patient with autologous stem cell transplantationSaving pediatric patient having cardiogenic shock, ventricular fibrillation due to fulminant myocarditis using VA-ECMOSaving young patient with multiple organ failure, acute respiratory distress syndrome caused by pneumoniaSuccessful treatment for patient having bilateral nephroblastoma

 Doctors checking the health condition and provide nutritional advice for patient Le Huynh K.C. Photo: T. Hien

The patient, Le Huynh K.C. (15 years old, from Huong So, Hue City), was admitted with sudden abdominal pain, vomiting, and subsequently fell into a coma and had seizures. Ms. Huynh T. Ph., K.C.'s mother, recounted: “Initially, he had mild abdominal pain, and after an examination, the doctor said it was intestinal inflammation and prescribed medication for home care and further observation. That night, 30 minutes after eating porridge, he vomited; later that night, he became exhausted and fainted, so the family called an ambulance to take him to the hospital at 3 a.m.”.

Upon examination, the Pediatric Intensive Care Unit of the Pediatric Center determined that this was a case of septic shock likely due to necrotizing pancreatitis, so they treated it intensively with broad-spectrum antibiotics and fluid resuscitation. Additionally, the hospital organized an urgent consultation involving the management board and specialists from Clinical Hematology, Pediatric Surgery, and Gastroenterology to establish a treatment plan. Test results indicated that the patient was experiencing continuous anemia with declining hemoglobin levels and disorders of both intrinsic and extrinsic coagulation.

The doctors decided to perform emergency surgery to control the bleeding, remove the severely necrotic pancreas, and repair the ruptured splenic vein that caused massive abdominal hemorrhage due to complications from necrotizing pancreatitis. The patient received nearly 3 liters of blood from the time of admission until the surgery and continued to receive blood during the operation. After surgery, K.C.'s condition still showed septic shock with multiple organ damage due to necrotizing pancreatitis, so the patient continued to be treated in the Pediatric Intensive Care Unit with mechanical ventilation, continuous blood filtration, and high-dose vasopressors, along with a combination of multiple broad-spectrum antibiotics

 Ms. Huynh T. Ph. and her child with the treatment team on the day of discharge. Photo: T. HIEN

According to the doctors at the Pediatric Center, the treatment process for Le Huynh K.C. faced many difficulties, requiring multiple interdisciplinary consultations because the patient showed signs of septic shock, progressive kidney damage, polyuria, severe hypertension, electrolyte imbalances, and progressive liver and lung damage.

After a week of intensive treatment, the patient no longer has a fever, lung and liver lesions have improved, and infection markers, organ function tests, and urine analysis have returned to normal. After more than a month, the patient has been discharged and scheduled for follow-up. The successful recovery of patient K.C. demonstrates the effectiveness of accurate diagnosis and the coordinated efforts of various specialized departments at the special-class general hospital in treating critical and rare cases. This is the first recorded case of severe necrotizing pancreatitis requiring continuous dialysis at the Pediatric Center.

Sharing in joy and gratitude, Ms. Huynh T. Ph., the mother of the patient, said: “Hearing that my child was in critical condition made me faint from despair, as my husband and I have only this one child. Our family can’t find the words to thank the doctors and nurses who worked tirelessly, day and night ,to care for K.C. During the days our child was on a ventilator in the Pediatric Intensive Care Unit, we could only pray for a miracle. Fortunately, Hue Central Hospital has modern equipment and a skilled medical team that monitored closely, allowing our child to be saved. Now, he is able to eat soft rice, and his health is gradually improving.”

According to medical literature, the incidence of acute pancreatitis in children is about 13.2 cases per 100,000 people each year. Hemorrhagic necrotizing pancreatitis is a very rare condition with a high risk of death if not treated promptly.

Story: L. GIANG
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