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Acute Terminal Ileitis in Children

A Retrospective Study in a Pediatric Emergency Department

Molina Gutiérrez, Miguel Angel, MD*; Martínez-Ojinaga Nodal, Eva, MD; Piñán Díez, Julia, MD; Rubio Aparicio, Pedro María, MD§; Alcolea Sánchez, Alida, MD*; Remesal Camba, Agustín, MD; Pérez Vigara, Ana, MD

doi: 10.1097/PEC.0000000000001461
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Objectives This study aims to describe the clinical presentation and outcome of patients diagnosed with acute ileitis in our pediatric emergency department.

Methods We performed a retrospective study of all patients diagnosed with terminal ileitis by abdominal ultrasonography findings in our pediatric emergency department, over the years 2013 and 2014. Patients with previous diagnosis of inflammatory bowel disease (IBD) were excluded. Data collected were clinical, radiological, and laboratory data at diagnosis; outcome including hospitalization care; and outpatient follow-up in pediatric gastroenterology and/or primary care.

Results A total of 20 cases were retrieved and studied. All of them presented with abdominal pain, 65% located in the right lower quadrant. Leukocyte count, C-reactive protein, and fibrinogen levels (means, 12,889; 4/μL; 50.1 mg/L; and 575 mg/dL, respectively) were above normal range. Hemoglobin and platelet count were normal. A microbial cause of ileitis was found in 3 cases (Yersinia enterocolitica, Campylobacter jejuni, and Adenovirus). Nine patients were referred to a pediatric gastroenterology unit. No cases of IBD were found.

Conclusions Acute ileitis is a rare and benign cause of abdominal pain in the pediatric emergency department. The main intervention on initial assessment is to rule out potentially severe causes of abdominal pain that could benefit of an emergency surgical procedure. In contrast with adults and adolescents, acute ileitis in children does not have a clear association with development of IBD.

From the *Pediatric Emergency Department,

Pediatric Gastroenterology and Nutrition Department, La Paz University Hospital, Madrid,

General Surgery Department, Virgen Macarena University Hospital, Sevilla;

§Pediatric Hematology/Oncology Department,

Pediatric Rheumatology Department, and

Pediatric Radiology Department, La Paz University Hospital, Madrid, Spain.

Disclosure: The authors declare no conflict of interest.

Reprints: Miguel Angel Molina Gutiérrez, MD, Pediatric Emergency Department, La Paz University Hospital, Paseo de la Castellana, 261, Madrid, Spain, 28046 (e-mail: malacatin@hotmail.com).

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