Acute pancreatitis (AP) is not a rare disease in children and adolescents and should be considered during the differential diagnosis of acute abdominal pain. It may be life-threatening if it is severe.
The etiology of acute pancreatitis in children is often drugs, infections, trauma to abdomen or anatomic abnormalities and in many cases, idiopathic (cause unknown). Bicycle handle injury or blunt trauma to upper abdomen can cause pancreatitis. Medications that may be associated with pancreatitis include anti-seizure medications(Valproic acid), chemotherapy agents(Azathioprine) and some antibiotics(Sulfonamides, Tetracycline) & Corticosteroids
Diagnosis of Acute Pancreatitis is based on clinical symptoms, serum pancreatic enzyme levels, and imaging studies. At least 2 out of the following 3 should be present to diagnose pancreatitis:
- Abdominal pain clinically suggesting a pancreatic origin,
- Serum amylase and/or lipase values ≥3 times upper limits of normal,
- Imaging findings suggestive of pancreatitis (bulky/inflamed pancreas, surrounding fluid).
Abdominal pain, irritability, epigastric discomfort, nausea and vomiting are the most common symptoms of AP in children. In children less than 5 years of age, symptoms may be subtle; therefore, a high level of suspicion is needed to diagnose AP.
Ultrasound and CT scan abdomen are the most common imaging modalities that are used to diagnose AP.