• 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
    IMAGE
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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:

    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:

    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 intenstine 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.

    RESOURCES

    Family Doctor—American Academy of Family Physicians http://familydoctor.org

    Nemours Kid's Health http://kidshealth.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Sick Kids—The Hospital for Sick Children http://www.sickkids.ca

    References

    Acute pancreatitis in children. The National Pancreas Foundation website. Available at: http://pancreasfoundation.org/patient-information/childrenpediatric-pancreatitis/acute-pancreatitis-in-children. Accessed December 28, 2015.

    Acute pancreatitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T127664/Acute-pancreatitis. Updated April 24, 2016. Accessed October 3, 2016.

    Pancreatic cysts and pseudocysts. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/health/diseases%5Fconditions/hic%5FPancreatitis/hic-pancreatic-cysts-and-pseudocysts. Updated April 24, 2014. Accessed December 28, 2015.

    Pancreatitis. Johns Hopkins Children’s Center website. Available at: http://www.hopkinschildrens.org/Pancreatitis.aspx. Accessed December 28, 2015.

    Pancreatitis. Nemours Kid's Health website. Available at: http://kidshealth.org/parent/medical/endocrine/pancreatitis.html. Updated April 2014. Accessed December 28, 2015.

    Pancreatitis in children. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/pancreatitis. Accessed December 28, 2015.

    Uretsky G, Goldschmiedt M, James K. Childhood pancreatitis. Am Fam Physician. 1999;59(9):2507-2512.

    8/28/2014 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T127664/Acute-pancreatitis: Johnson CD, Besselink MG, Carter R. Acute pancreatitis. BMJ. 2014;349:g4859.

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