Pancreatitis in Children

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What is pancreatitis?

Pancreatitis is an inflammation, or swelling, of the pancreas. This organ in the upper abdomen produces enzymes involved in the digestion of proteins, fats, and sugars. The pancreas also produces insulin and other hormones that help the body to maintain normal blood sugar levels.

In children, pancreatitis is generally caused by viruses and other infections, medications, gallstones, congenital malformations and other inherited conditions, and trauma to the abdomen.

In one out of four childhood cases, however, no cause is identified.

What are the symptoms of pancreatitis?

This condition is often accompanied by pain in the upper abdomen and/or back. This pain may develop slowly, be mild and of short duration. Yet it may also start suddenly, be more severe, and longer lasting.

Nausea and vomiting are also very common. A child may also shows sign of fever and jaundice (yellowing of the skin).

How is pancreatitis diagnosed?

• Laboratory tests to detect higher than normal levels of some of the proteins produced by the pancreas, such as amylase and lipase.
• An abdominal ultrasound (sonogram), CT scan (computed tomography), or MRI (magnetic resonance imaging) of the abdomen to evaluate show inflammation and swelling of the pancreas and surrounding tissues and help identify structural abnormalities.
• Once pancreatitis is diagnosed, other blood tests are done to search for a cause and identify any complications due to the inflammation.
• Repeated inflammation of the pancreas is rare, but when it occurs it may lead to chronic problems with digestion, diabetes, and recurrent or persistent pain. In these cases, we may perform additional specialized tests such as an ERCP (endoscopic retrograde cholangiopancreatography) or MRCP (magnetic resonance cholanglopancreatography).

Our specialists have the rare expertise of performing ERCP in children. The test consists of the passage of a narrow flexible tube with a camera and a light through the mouth down inside the small intestine to look at the bile duct and pancreatic duct.

How is pancreatitis treated?

Treatment mainly consists of allowing the pancreas to rest (i.e. no eating or drinking) and relieving any associated pain.

Initially, we place an intravenous line (IV) to give fluids and medications. Typically, liquids, and then food, are reintroduced within a few days, either by mouth or through a feeding tube (called a nasogastric or nasoduodenal tube).

Most children recover within a week, with no permanent damage to the pancreas.