Acute Spinal Epidural Abscess Presenting with Abdominal Pain in a Child

급성복통을 동반한 소아의 척추 경막외 농양 1예

Spinal epidural abscess(SEA) is a rare condition in children. Classic symptoms are spinal ache, root pain, weakness and paralysis. The earliest symptoms of SEA in the pediatric age group are nonspecific and variable. Early diagnosis may be almost impossible when local spinal pain is inconspicuous or absent, when toxic epiphenomena divert attention from subtle signs of neurologic dysfunction and when the patient is an acutely distressed and uncooperative child. Failure to diagnosis and treat condition on a timely basis may lead to permanent neurolgic dysfunction or even death. This infection, usually located in the dorsal epidural space of the mid thoracic or lower lumbar regions, is the result of hematogenous dissemination of bacteria, usually Staphylococci, from foci of infection in the skin, or respiratory or urinary tracts. MRI was the diagnostic method of choice. A combination of antibiotics and surgical drainage remains the treatment of choice. Prognosis is excellent if surgery is performed before the development of neurologic deficit. We report a case of SEA in a child whose first presenting symptom was abdominal pain rather than spinal pain. A case is diagnosed by MRI and successfully treated with laminectomy and drainage and antibiotics.

저자들은 발열과 복통을 주소로 입원한 환아에서 연속적으로 요통 및 둔부 동통을 보여 실시한 자기 공명촬영상 요추 부위의 척추 경막외 농양을 진단하고 수술하였기에 문헌 고찰과 함께 보고하는 바이다.