A Child with Severe Malaria Presenting with Acute Surgical Abdomen (Duodenal Perforation).

Tika Ram Bhandari,Nagendra Chaudhary,Rajesh Poudel,Sudha Shahi

doi:10.1155/2016/3092130

Tika Ram Bhandari, Nagendra Chaudhary + Show 2 more

Open Access

https://doi.org/10.1155/2016/3092130

Copy DOI

Abstract

Plasmodium falciparum, the commonest cause of severe malaria in children, is an important cause of mortality in developing nations like Nepal. Duodenal perforation in a case of complicated malaria, although a rare entity, can occur in children. Early diagnosis, proper medical treatment, and early surgical repair can be a lifesaving measure in such cases. Here, we report a case of a 5-year-old male child with falciparum malaria complicated by a duodenal perforation that was successively managed with appropriate antimalarial drugs and early surgical repair.

Highlights

Duodenal perforation in children is a rare surgical emergency often missed or not considered commonly in the differential diagnoses of acute abdomen [1, 2]
Severe malaria caused by P. falciparum can present with unarousable coma, loss of consciousness, metabolic acidosis, hypoglycemia, increased lactate, jaundice, acute kidney injury, cardiac failure, hyperparasitemia, and pulmonary edema [3]
Dyspepsia, abdominal pain, intestinal hemorrhage, and obstruction are well known in acute malaria [4,5,6,7]

Summary

Introduction

Duodenal perforation in children is a rare surgical emergency often missed or not considered commonly in the differential diagnoses of acute abdomen [1, 2]. Peptic ulcer disease (PUD) in children is reported worldwide with an estimated frequency of 8.1% in Europe and 17.4% in the US, remaining relatively rare as compared with adults. Severe malaria caused by P. falciparum can present with unarousable coma, loss of consciousness, metabolic acidosis, hypoglycemia, increased lactate, jaundice, acute kidney injury, cardiac failure, hyperparasitemia, and pulmonary edema [3]. Dyspepsia, abdominal pain, intestinal hemorrhage, and obstruction are well known in acute malaria [4,5,6,7]. Reports on intestinal perforations associated with malaria are few

Case Presentation

Discussion

Findings

Conclusion