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Date of last update: 10/15/2017.

Forum Name: Gastroenterology Topics

Question: 9-year-old w/abdominal pain, vomiting, headache, sore throat

 angiesmith74 - Sun Sep 14, 2008 11:17 pm

My 9-year-old son has suffered from abdominal pain, vomiting, headache, and sore throat since March of this year. He got somewhat better over the summer, so we almost thought it was maybe a bit psychological. Every day, the school would call me because he was sick with the above symptoms. He missed a lot of school.
Routine blood tests in April revealed SGPT levels of 54, a little high, and he re-tested in June at 42. Still a little high, but normalizing.
He did not respond at all to a variety of medicines for GERD. He has a history of food and environmental allergies, and is on a cocktail of allergy meds and is currently undergoing immunology therapy.
Fast-forward to August. School was in session for four days and my son became suddenly very ill again with the same symptoms. Except this time he seemed very fatigued. He said he felt "depressed". He cried with abdominal pain. Abdominal ultrasound revealed no obvious abnormalities. However, bloodwork showed elevated lymphocytes and monocytes. The nurse-practitioner suspected mononucleosis, gave me that diagnosis, and never told me any differently. However, when I requested my son's medical records to take to a Pediatric GI, I noticed the monospot test was negative. He also tested negative for EBV. This was exactly one month ago.
My son is still sick. He vomits at least 2-3x daily. He says his insides feel "like they're going to explode". He tries to keep himself distracted with video games to "not think about the pain." He asks me if I know how bad he hurts. His allergies are worse. I've tried to rule out a food allergy, but we can't seem to. I grew frustrated with his allergist and "fired" her. I made an appointment with another one at Vanderbilt Children's. They're so far behind that I made that appointment in June and he couldn't get in until October 14th.
We've started to see a GI Dr. at Vanderbilt Children's. The first round of tests revealed nothing acutely wrong (it was a barium swallow done on 09/12).
He's scheduled for an upper and lower endoscopy in about a week.
Nothing helps his pain. I dread the next week. My son hasn't been able to go to school. He was taking Levsin, and a pediatric version of a GI cocktail, but neither helped at all. I finally k.o.'ed him with some Atarax the other day; it was left over from a dental appointment he'd had. Interestingly, he was better for about 24 hours. I felt guilty about "doping" my son, but he rested and felt and looked better.
I'm trying to be positive that the endoscopy will reveal what's wrong. The doctor mentioned a few possibilities; H. Pylori, Celiac Disease, Allergic Esophagitis...he pretty much ruled out GERD because my son hadn't responded to the meds. After going through the motions for six months, I am losing faith and watching my son grow weary and depressed. I realize that I'll probably get a "wait and see about the endoscopy" answer from any medical professional who might read this, but that's a week away and I've got a miserable kid here. What's puzzling me is that no one can seem to find anything acutely wrong, so we always get sent home, only to suffer some more.
Thanks for any input!
 John Kenyon, CNA - Sat Mar 07, 2009 12:40 am

User avatar Hello --

I realize your post has been sitting here for a very long time, so I hope by now things have resolved or been resolved, but since I am trying to clean up loose ends here, I read through this several times, and in case the problem has not yet been solved, I have an idea: has anyone suggested or looked into the possibility that your son may have pancreatitis? This is relatively rare, but it does happens, the symptoms and limited labs do fit the profile, and it is often quite a challenge for clinicians to diagnose. It's probably overlooked a good deal of the time, then resolves before it's discovered. The one possible reason for a prolonged bout of this would be formation of a pseudocyst, which could cause the problem to continue on indefinitely unless discovered and treated aggressively.

While the prognosis is generally good in these cases, the problem only gets better when it is discovered. The fact that your son seemed to respond positively to Atarax is also interesting, since this drug, old and simple as it is, seems to sometimes have a salutory effect on the symptoms of pancreatitis in children, at least for a limited period.

Hopefully the endoscopy was telling and led to something that could be treated and that by now things are better. If not, the next step would likely be an Endoscopic retrograde cholangiopancreatography (ERCP). This is a more in-depth (literally) sort of exam rather like a grand edoscopy, and allows visualization of the common duct, gallbladder and pancreas.

Please forgive the length of time it took to get to your question, but there has been a remarkable backlog of questions. Please also follow up with us here and update us as to the findings of the GI consult. Again, I hope by now the problem has either resolved or been handled and all is well again. My best to you.

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