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Pediatric pancreatitis

  My 10 year old has had two attacks of acute pancreatitis. These seem to come on very suddenly and be unrelated to any condition such as diet or trauma or drinking alcohol, obviously. There seems to be no treatment except morphine for pain and intravenous fluids. There seems to be no literature on childhood pancreatitis. Can you give me any information about the cause, prognosis and any preventative steps we could take.I submitted this question to the Gastroenterology Forum and it referred me to this section.
Dear Celia :
There are many causes of pancreatitis in childhood , viral etiology including mumps , infectious mononucleosis , influenza A, german measles , and Coxsackie B virus .
These would produce a clinical picture of acute pancreatitis with severe epigastric pain , severe enough to cause the child to assume a sitting position , radiating to the back , persistent vomiting and fever .
If the pancreatitis is due to a viral uncomplicated infection , the prognosis is good .
Other causes include abdominal trauma , obstruction of the pancreatic drainage system by biliary duct sludging or pancreatic protein precipitations , hereditary ( familial cases have been reported ) , drugs , and numerous systemic diseases which make diagnosing a cause for pancreatitis quite difficult unless other manifestations of the systemic disease are apparent at the same time or prior to the attack .
If your child has had two episodes of pancreatitis ,a gastroenterology consult is necessary . A search for other possibilities such as hyperlipidemia , hyperparathyroidism , ascariasis and cystic fibrosis is warranted . Plain abdominal X-rays maybe done , an abdomial ultrasound and or an ERCP to exclude pancreatic drainage system obstruction ( please discuss the need for all these investigations with the gastroenterologist as some may not be indicated in individual cases ).
Management of an acute episode may include taking nothing by mouth , nasogastric suction , pain medication , IV nutrition ( TPN ), very rarely would surgery be required .
If the cause is unknown , there is little you can do to prevent recurrent pancreatitis . A care plan is necessary to be discussed with both the pediatrician and gastroenterologist on when to bring your child for follow-up and when hospitalization is required .
Thank you for your question
Disclaimer : this information is presented for educational purposes only. Your physician is ultimately responsible for diagnosis , and treatment .
Keywords : pediatric pancreatitis* ( gastroenterology )

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