Causes of pancreatitis in children are different from adults, which include biliary abnormalities, medications, idiopathic, systemic disease and trauma (1). These causes may co-exist and it may be challenging to delineate the actual cause of pancreatitis.
Two of the three features including abdominal pain, elevated serum pancreatic enzymes or imaging findings are needed to diagnose acute pancreatitis (1,6). Epigastric pain and vomiting are common in children (7). A high index of suspicion is needed as signs and symptoms are often non-specific. Acute pancreatitis leads to an increase in serum amylase and lipase and an elevated level more than 3 times the upper limit of normal is needed to be counted as a criterion above (1,6). Serum lipase …show more content…
Management of pancreatitis is supportive, including the use of intravenous fluids, analgesics and anti-emetics. Early total enteral feeding is recommended as it reduces the rate of infectious complications in severe pancreatitis occurring in adults as compared to total parenteral feeding (13). However, studies (1,7, 9) have found that majority of patients were made nil by mouth at admission, total parenteral nutrition was given to patients with severe disease and very few enteral feedings were attempted. Admission to intensive care unit is recommended for patients likely to have severe pancreatitis based on the scoring system (11). Overall, course of illness was found to last for 4 to 7 days (9) and a mortality rate of 2% to 6.5% (9, 11).
Pancreatitis in children is clearly different from adult pancreatitis. Determining the aetiology of pancreatitis in children is often guesswork and the lack of a well-studied severity scoring system results in management dilemmas and it is probably safer to transfer to ICU when severe pancreatitis is suspected clinically. Enteral nutrition has a role in the management and should be
Two of the three features including abdominal pain, elevated serum pancreatic enzymes or imaging findings are needed to diagnose acute pancreatitis (1,6). Epigastric pain and vomiting are common in children (7). A high index of suspicion is needed as signs and symptoms are often non-specific. Acute pancreatitis leads to an increase in serum amylase and lipase and an elevated level more than 3 times the upper limit of normal is needed to be counted as a criterion above (1,6). Serum lipase …show more content…
Management of pancreatitis is supportive, including the use of intravenous fluids, analgesics and anti-emetics. Early total enteral feeding is recommended as it reduces the rate of infectious complications in severe pancreatitis occurring in adults as compared to total parenteral feeding (13). However, studies (1,7, 9) have found that majority of patients were made nil by mouth at admission, total parenteral nutrition was given to patients with severe disease and very few enteral feedings were attempted. Admission to intensive care unit is recommended for patients likely to have severe pancreatitis based on the scoring system (11). Overall, course of illness was found to last for 4 to 7 days (9) and a mortality rate of 2% to 6.5% (9, 11).
Pancreatitis in children is clearly different from adult pancreatitis. Determining the aetiology of pancreatitis in children is often guesswork and the lack of a well-studied severity scoring system results in management dilemmas and it is probably safer to transfer to ICU when severe pancreatitis is suspected clinically. Enteral nutrition has a role in the management and should be