What is the definition of Childhood Pancreatitis?

Pancreatitis in children, as in adults, occurs when the pancreas becomes swollen and inflamed.

What are the causes for Childhood Pancreatitis?

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:

  • After an organ or bone marrow transplant
  • Cystic fibrosis
  • Crohn disease and other disorders, when the body's immune system attacks and destroys healthy body tissue by mistake
  • Type 1 diabetes
  • Overactive parathyroid gland
  • Kawasaki disease

Sometimes, the cause is unknown.

What are the symptoms for Childhood Pancreatitis?

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

What are the current treatments for Childhood Pancreatitis?

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 within 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

What is the outlook (prognosis) for Childhood Pancreatitis?

Most cases go away in a week. Children usually 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.

What are the possible complications for Childhood Pancreatitis?

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 should I contact a medical professional for Childhood Pancreatitis?

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
  • Severe upper abdominal pain and vomiting

How do I prevent Childhood Pancreatitis?

Most of the time, there is no way to prevent pancreatitis.

REFERENCES

Connelly BL. Acute pancreatitis. In: Long SS, Prober CG, Fischer M, eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 63.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Pancreatitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 378.

Vitale DS, Abu-El-Haija M. Pancreatitis. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 82.

  • Condition: Children with Choledochal Malformation (CM)
  • Journal: Khirurgiia
  • Treatment Used: Mini-Laparotomy Roux-en-Y Hepaticojejunostomy
  • Number of Patients: 39
  • Published —
The study researched the use of mini-laparotomy Roux-en-Y hepaticojejunostomy for children with choledochal malformation (CM).
  • Journal: Canadian journal of gastroenterology & hepatology
  • Published —
Conjugated Hyperbilirubinemia in Infants: Is There Still a Role for ERCP?
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Behavioral
  • Participants: 260
  • Start Date: April 25, 2019
A Randomized Trial of a Web-based Non-pharmacological Pain Intervention for Pediatric Chronic Pancreatitis
Clinical Trial
  • Status: Not yet recruiting
  • Phase: Phase 2
  • Intervention Type: Drug
  • Participants: 50
  • Start Date: June 1, 2021
Initial Pain Management in Pediatric Pancreatitis: Opioid vs. Non-Opioid