Pancreatitis - children

  • Definition
    • Pancreatitis in children occurs when the pancreas becomes swollen and inflamed.

  • Causes
    • The pancreas is an organ behind the stomach.

      It produces chemicals called enzymes, which are needed to digest food. Most of the time, the enzymes are only active after they reach the small intestine.

      When these enzymes become active inside the pancreas, they digest the tissue of the pancreas. This causes swelling, bleeding  and damage to the organ and its blood vessels. This condition is called pancreatitis.

      Common causes of pancreatitis in children include:

      • Trauma to the belly, such as from a bicycle handle bar injury
      • Blocked bile duct
      • Side effects of medicine, such as anti-seizure medicines, chemotherapy, or some antibiotics
      • Viral infections, including mumps and coxsackie B
      • High blood levels of a fat in the blood called triglycerides

      Other causes include:

      Sometimes, the cause is unknown.

  • Symptoms
    • The main symptom of pancreatitis in children is severe pain in the upper abdomen. Sometimes the pain may spread to the back, lower abdomen, and front part of the chest. The pain may increase after meals.

      Other symptoms may include:

      • Cough
      • Nausea and vomiting
      • Swelling in the abdomen
      • Fever
      • Yellowing of the skin, called jaundice
      • Loss of appetite
      • Increased pulse
  • Exams and Tests
  • Treatment
    • Treatment may require a stay in the hospital. It may involve:

      • Pain medicines
      • Stopping food or fluids by mouth
      • Fluids given through a vein (IV)
      • Anti-nausea medicines for nausea and vomiting
      • Low-fat diet

      The provider may insert a tube through the child's nose or mouth to remove contents of the stomach. The tube will be left in for one or more days. This may be done if vomiting and severe pain don't improve. The child also may be given food through a vein (IV) or a feeding tube.

      The child can be given solid food once they stop vomiting. Most children are able to take solid food with 1 or 2 days after an attack of acute pancreatitis.

      In some cases, therapy is needed to:

      • Drain fluid that has collected in or around the pancreas
      • Remove gallstones
      • Relieve blockages of the pancreatic duct
  • Outlook (Prognosis)
    • Most cases go away in a week. Usually, children recover completely.

      Chronic pancreatitis is rarely seen in children. When it occurs, it is most often due to genetic defects or birth defects of the pancreas or biliary ducts.

  • Possible Complications
    • Severe irritation of the pancreas, and pancreatitis due to blunt trauma, such as from a bike handle bar, can cause complications. These may include:

      • Collection of fluid around the pancreas
      • Buildup of fluid in the abdomen (ascites)
  • When to Contact a Medical Professional
    • Call the provider if your child shows symptoms of pancreatitis. Also call if your child has these symptoms:

      • Intense, constant abdominal pain
      • Develops other symptoms of acute pancreatitis
  • Prevention
    • Most of the time, there is no way to prevent pancreatitis.

  • References
    • Kliegman RM, Stanton BF, St Geme JW, Schor NF. Pancreatitis. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 351.

      Lowe ME. Pancreatitis. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 82.

      Marcdante KJ, Kliegman RM.  Pancreatic disease. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 7th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 131.