All About Pancreatitis In Children

Pancreatitis in children

is relatively rare. It is an acute inflammation of the pancreas. The pancreas is a large glandular organ which has both endocrine and exocrine functions. Endocrine function would include secretion of the very important hormone insulin. Exocrine function would be the secretion of digestive enzymes.

Enzymes secreted from the pancreas flow through the pancreatic duct into the duodenum and help in breaking down food. When the pancreas is inflamed the flow of the pancreatic enzymes are inhibited and the enzymes start destroying the tissues of the pancreas itself. This condition is also known as Acute Pancreatitis or Necrotizing Pancreatitis.

Acute pancreatitis

Causes of Pancreatitis in Children

In adults, chronic alcohol abuse is the most widespread cause of the condition. The predominant causes of the disease in children are as follows:

  • Abdominal Trauma:

    In the United States, abdominal trauma is responsible for 15-37% of such cases in children. Any blunt injury sustained to the abdomen has been associated with the prevalence of the disease in children.

  • Mechanical Obstruction of the Pancreatic Ducts:

    Gall bladder stones may flow in with the bile and cause obstruction in the pancreatic ducts. Presence of round worms may also cause mechanical obstruction in the pancreatic ducts. As a result, the accumulated pancreatic enzymes start destroying the cells and tissues of the pancreas.

  • Heredity Disorders of the Pancreas:

    In the United States, about 1000 individuals are reported to be affected by this condition. A genetic mutation causes the enzyme cationin trypsinogen to be activated in the pancreas. Normally the enzyme is not activated in the pancreas. The abnormal genetic mutation causes the enzyme to self destruct the cells of the pancreas.

  • Cystic Fibrosis:

    It is the most common inherited disease which leads to the development of chronic pancreatitis. It is a genetic disorder which affects the lungs and the digestive system. A sticky mucus builds up in the tissues of the lungs and the digestive system. A characteristic side effect of the disease would be the scarring of tissues in the pancreas coupled with the formation of cysts. This particular faulty gene is responsible for the secretions like sweat, digestive juices and mucus.

  • Drugs:

    This condition is very commonly caused by the medications like azathioprine, tetracycline, L-asparagine, valporic acid, steroids, Non Steroidal Anti Inflammatory Drugs (NSAIDs) etc in a lot of children.

  • Congenital Defects:

    Defects present at birth like pancreas divisum ( two parts of the pancreas do not join to form a pancreatic duct), malformed pancreato-biliary junction, sphincter of oddi dysfunction ( the sphincter muscle does not open normally and causes a blockage for the digestive enzymes to pass through), choledochal cysts (Cysts in the bile ducts) etc can bring in an acute bout of pancreatitis.

  • Systemic Infection:

    A systemic infection especially which is viral in nature like that of mumps, rubella, coxsackie virus B, Human Immunodeficiency Virus etc may cause it in children.

  • Metabolic abnormalities:

    Being born with metabolic abnormalities like hyperlipidemia (presence of excess lipids like cholesterol and triglycerides in the blood stream) or hypercalcemia (presence of excess calcium in the blood stream) etc.

  • Symptoms of Acute Pancreatitis

    • Upper abdominal pain which radiates towards the back
    • Nausea
    • Vomiting
    • Abdominal tenderness
    • Abdominal distention
    • Weight loss
    • Fever
    • Ascites
    • Jaundice
    • Abdominal hemorrhage on rare occasions

    Treatment of Pancreatitis in Children

    • Hospitalization is required for administering intravenous drip, nasogastric feeding and pain management.
    • Nasogastric suction of fluid and air from the abdomen becomes essential to control vomiting in children.
    • Nasogastric feeding is required to bypass the requirement of the pancreatic enzymes to break down food. The pressure on the pancreas is taken away due to this and it is allowed to rest and heal.
    • Antibiotics are needed to treat the recurrent infection.
    • Antacids and H2 blockers are required to manage the signs of gastritis.
    • Surgery may be needed to fix congenital defects, cysts or recurrent gastrointestinal bleeding.

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