以腹痛、淀粉酶升高为主要表现的糖尿病酮症酸中毒肥胖患儿误诊为急性胰腺炎临床分析OACSTPCD

Objective To investigate the causes of misdiagnosis of diabetic ketoacidosis(DKA)as acute pancreatitis and preventive measures in obese children with abdominal pain and elevated amylase as the main manifestations.Methods The clinical data of 6 obese children with misdiagnosed DKA admitted to our hospital from April 2022 to May 2023 were retro-spectively analyzed.Results Six patients presented with persistent severe abdominal pain,middle and upper abdominal ten-derness,and elevated hematuric amylase.Abdominal B-ultrasonography showed slight enlargement of the pancreas in all pa-tients,and acute pancreatitis was initially diagnosed.After the symptomatic treatment,abdominal pain was not relieved.The duration of misdiagnosis was 7 to 20 h.The diagnosis of DKA was made based on medical history,laboratory and abdominal CT examination.They were treated with fluid rehydration,intravenous infusion of low-dose insulin,correction of acid-base im-balance and water and electrolyte disorder for 1-3 d,and the condition was relieved.Conclusion For patients with unex-plained abdominal pain and elevated amylase,it is necessary to inquire about the history of diabetes or family history of diabe-tes,develop diagnostic thinking,carefully perform physical examination and differential diagnosis,and conduct relevant tests as soon as possible,so as to improve the diagnosis rate of DKA.