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Early Enteral Feeding After Distal Pancreatectomy May Contribute To Chyle Leak

Takehiro Noji, Toru Nakamura, Yoshiyasu Ambo, On Suzuki, Fumitaka Nakamura, Akihiro Kishida, Satoshi Hirano, Satoshi Kondo, Nobuichi Kashimura
Published 2012 · Medicine, Biology
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A 13-year-old boy was admitted to the emergency department with acute abdominal pain associated with vomiting that started a few hours before admission. No fever was reported. The patient had recently undergone a laparoscopic appendectomy, and he had been discharged on the third postoperative day in good conditions. Physical examination showed diffused abdominal tenderness and guarding. Blood tests revealed an increase of serum amylase (1125 IU/L; reference range, G100 IU/L) and lipase (727 IU/L; reference range, 16Y63 IU/L). White blood cell count, electrolyte values, liver function, and renal function were within normal limits. An abdominal ultrasound was performed at admission, and no liver, gallbladder, or pancreatic anomalies were found. A subsequent magnetic resonance cholangiopancreatography was performed on day 4, but no gallstones or pancreaticobiliary anomalies were detected. The patient tested positive for IgM anti-HSV, immunization for rubella (high IgG tritate), and negative for IgM antiCMV, anti-EBV, and Toxoplasma gondii. The patient was treated conservatively for acute pancreatitis, and oral feedings were initiated 72 hours after the admission and were well tolerated. The patient was discharged 7 days after the admission with normal biochemical parameters. After 3 months, the child is well, and serum sample showed seroconversion.
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