9 yr old son - short gut - pancreatitis-liver cyst

[daree]

I was very ill during 1st trimester of pregnancy with my 9 yr old son. I leaked amniotic fluid which showed that son had bowel obstruction.  Perforated bowel in small intestine. Approx 52% removed at birth.  Dr. sewed lots of little sections together so he was not extremely short gut.  TPN (Hyperal) approx 2 mos.  He was born w/liver calcifications which a few weeks later caused sludge in gall bladder, causing white BM's.  Bear hormone cleared up sludge and BM's returned to natural color.  No sickness or hospitalizations for 9 yrs.  His only medical problems are seasonal asthma(oct-jan) and some skin rashes on forehead and stomach area and fingers.  He awoke one night screaming with abdominal pain.  Earlier in the evening complained w/runny nose and dizziness and generally not feeling well.  ER doctor said in amylase was over 400 and liapase was 4500.  He was admitted for 2 nights, IV fluids only.  CT scan did not show anything.  At my urging, a week later Dr. did ultrasound of gall bladder.  He saw no stones but there is a small cyst in his liver.  Dr. does not feel any follow-up is necessary. Amylase and Liapase are bot under 100 now, but the AST (old SGOT) is 68. He sometimes complains of feeling the need to urinate and cannot, this has always went away in a few hrs. My maternal instincts tell me, something is not right.  Please advise,  Thank You

[Kevin Pho, MD]

Pancreatitis in children certainly should be a concern and further evaluation warranted.  Possible causes would include an obstruction of the pancreatic duct due to a congenital abnormality, hereditary pancreatitis, a form of cystic fibrosis, or Crohn's disease (amongst others).  

The next consideration if the the ultrasound and CT were negative would be an ERCP or MRCP to evaluate the ducts for blockages or stones.  

I would suggest a pediatric gastroenterologist for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[surgeon]

The liver cyst probably means nothing; they are fairly common and rarely have significance. However, it's very important, in my opinion, to have an explanation as to why a 9 year old would get pancreatitis. I'd suggest he see a pediatric gastroenterologist.