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Of bellyache
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Of bellyache Babies and small children with "colds" or upper respiratory tract infections (URI) frequently c r y with abdominal and epigastric pain. The URI, without microbiologic isolations and detailed investigations, are attributed to a viral agent, and the epigastric and abdominal pain to "intestinal colic." But, the evidence to support the etiologic diagnosis or pathogenesis for the pain is usually lacking. The diagnosis of intestinal colic may be applicable in some instances. This is an old traditional concept based upon little study. However, from recent studies, 1-3 it seems likely that the abdominal pain could represent acute viral pancreatitis. M a n y of the viruses that produce URI in man, especially in very young people, are small and are associated with a viremia. They can produce generalized arteritis (the possible beginning of arteriosclerosis), phlebitis, valvulitis, myocarditis, pericarditis, sympathetic ganglionitis, hepatitis and many other organ infections, including pancreatitis {even with juvenile diabetes at times) and bellyache from viral pancreatitis and/or myenteric plexus neuritis. Do not
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ignore the bellyache; it may not necessarily be merely benign intestinal colic. It may be pancreatitis. Many serious illnesses, including viral heart disease, start with a U R I and are heralded with a "bellyache."
G. E. Burch, M.D. Tulane University School of Medicine and Charity Hospital of Louisiana New Orleans, Louisiana REFERENCES
1. Tsui, C. Y., Burch, G. E., and Harb, J. M.: Pancreatitis in mice infected with Coxsackievirus B1, Arch. Pathol. 93:379, 1972. 2. Burch, G. E., Tsui, C. Y., and Harb, J. M.: Pancreatic islet cell damage in mice produced by Coxsackie B 1 and encephalomyocarditis viruses, Experientia 28:310, 1972. 3. Butch, G. E., Tsui, C. Y., and Harb, J. M.: Pancreatitis of mice infected with encephalomyocarditis virus, Pathol. Microbiol. 40:281, 1974.
November, 1977, Vol. 94, No. 5
Of bellyache Babies and small children with "colds" or upper respiratory tract infections (URI) frequently c r y with abdominal and epigastric pain. The URI, without microbiologic isolations and detailed investigations, are attributed to a viral agent, and the epigastric and abdominal pain to "intestinal colic." But, the evidence to support the etiologic diagnosis or pathogenesis for the pain is usually lacking. The diagnosis of intestinal colic may be applicable in some instances. This is an old traditional concept based upon little study. However, from recent studies, 1-3 it seems likely that the abdominal pain could represent acute viral pancreatitis. M a n y of the viruses that produce URI in man, especially in very young people, are small and are associated with a viremia. They can produce generalized arteritis (the possible beginning of arteriosclerosis), phlebitis, valvulitis, myocarditis, pericarditis, sympathetic ganglionitis, hepatitis and many other organ infections, including pancreatitis {even with juvenile diabetes at times) and bellyache from viral pancreatitis and/or myenteric plexus neuritis. Do not
668
ignore the bellyache; it may not necessarily be merely benign intestinal colic. It may be pancreatitis. Many serious illnesses, including viral heart disease, start with a U R I and are heralded with a "bellyache."
G. E. Burch, M.D. Tulane University School of Medicine and Charity Hospital of Louisiana New Orleans, Louisiana REFERENCES
1. Tsui, C. Y., Burch, G. E., and Harb, J. M.: Pancreatitis in mice infected with Coxsackievirus B1, Arch. Pathol. 93:379, 1972. 2. Burch, G. E., Tsui, C. Y., and Harb, J. M.: Pancreatic islet cell damage in mice produced by Coxsackie B 1 and encephalomyocarditis viruses, Experientia 28:310, 1972. 3. Butch, G. E., Tsui, C. Y., and Harb, J. M.: Pancreatitis of mice infected with encephalomyocarditis virus, Pathol. Microbiol. 40:281, 1974.
November, 1977, Vol. 94, No. 5