Pediatric pancreatitis: What is it and how is it treated?
Pancreatitis, an uncommon condition in pediatric patients, is characterized by the inflammation of the pancreas, clinical signs of epigastric abdominal pain and elevated serum digestive enzymes. It can present at any age. The child may have sudden abdominal pain with vomiting. Some children may require ICU admission because of low blood pressure, fluid in the abdomen or chest.
There are many cause for pancreatitis in children. Some are due to birth structural abnormalities of the duct draining the pancreas. Others are blood or hormone-related issues. Some are dietary or environmental or genetic.
The initial treatment is medicinal with endoscopic intervention, if required. Some children may require surgery. In an acute setting, if the pancreas is badly damaged, parts of it may need to be removed. If there is abnormal fluid collection, that may need to be drained as well.
In some children, repeated pancreatitis may cause chronic changes. This may lead to chronic pain, poor digestion and poor weight gain. In these children, part of the damaged pancreas may be removed and the intestines will be connected to the pancreas directly. In some children, the duct draining the pancreas may be blocked and may swell up inside the pancreas. In such a case, the small intestine may be attached to bypass and drain the pancreas.
Children with pancreas-related diseases need a multidisciplinary approach and careful decision-making regarding surgery.