Acute Pancreatitis Child

Definition

The pancreas is a long, flat organ located behind the stomach. It creates enzymes that help digest food as well as hormones, like insulin, that help control blood sugar.

Acute pancreatitis is inflammation of the pancreas that occurs suddenly.

The Pancreas

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Causes

The most common cause of pancreatitis in children is trauma to the abdomen.

Other causes include:

• The use of certain medications
• Specific viral infections
• Ischemia—lack of blood supply to the pancreas

Sometimes the cause of acute pancreatitis in children is unknown.

Risk Factors

Factors that may increase your child’s risk of acute pancreatitis include:

• Taking certain medications
• Specific viral infection
• Congenital abnormalities
• Hyperlipidemia—excess lipids (fats) in the blood
• Hypercalcemia—excess calcium in the blood
• Cystic fibrosis
• Gallstones
• Vasculitic diseases, such as systemic lupus erythematosus, Henoch-Schönlein purpura

Symptoms

Symptoms may include:

• Pain and swelling in the abdomen
• Back pain or left shoulder pain
• Nausea and vomiting—vomit may be yellow, green, or brown
• Loss of appetite
• Fever

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. Blood will be taken for testing as well.

Images may be taken of your child’s bodily structures. This can be done with:

• Abdominal ultrasound
• Contrast-enhanced CT scan
• MRI scan

Treatment

Pancreatitis may resolve on its own. Supportive care may be needed if your child has frequent vomiting and poor appetite. To replace fluids and provide nutrition, your child’s doctor may advise:

• IV fluids
• Total parenteral nutrition—nutrition given by IV
• A feeding tube

Your child may also be given supplemental oxygen.

If your child’s condition does not improve on its own or is severe, your child’s doctor will talk to you about a treatment plan. Options include:

Dietary Changes

Your child’s doctor may advise dietary change and plenty of fluids to promote healing of the pancreas.

Medications

Your child’s doctor may advise the following medication:

• Over-the-counter pain medication
• Prescription pain medication
• Antibiotics if an infection is present or possible
• Anti-nausea medication

Talk to your child’s doctor about the medications that your child takes. Certain medications may need to be stopped or changed if they are the cause of the acute pancreatitis.

Surgery

Surgery may be needed if your child has complications, such as bleeding, infection, or uncontrolled pain.

Another complication is the formation of cysts and pseudocysts. Cysts are fluid-filled sacs in or on the pancreas. A pseudocyst contains enzymes or semi-solid material that form in spaces inside the pancreas. Cysts and pseudocysts may cause pain, nausea, vomiting, or become infected. Treatment may include:

• Drainage with laparoscopic surgery, endoscopy (inserting a tube down the throat and into the small intestine and pancreas) or by inserting a catheter into the abdomen.
• Pancreatic surgery with removal of the cyst or pseudocyst, along with the affected part of the pancreas.

Prevention

If your child has very high triglycerides or other known causes of pancreatitis, talk to their doctor about treatment options to help reduce the chance of pancreatitis.