Objective: Pancreatitis is a rare cause of abdominal pain in childhood. Advances in imaging techniques for pancreatic disease have enabled earlier clinical and etiological diagnosis, thus improving treatment possibilities. The aim of this study was to analyze the etiology, diagnostic methods, and management in patients with pancreatitis diagnosed in our hospital in the last 10 years.
Material and methods: We reviewed the children aged 0-16 years with a diagnosis of pancreatitis admitted to our hospital between 1990 and 2000. Diagnostic criteria were symptoms suggestive of pancreatitis and hyperamylasemia.
Results: There were 8 females and 1 male. The median age was 11.5 years (range: 7-16 years). Laboratory findings were as follows: mean amylase level was 1601 U/l and mean lipase level was 506 U/l. Imaging tests: ultrasonography, abdominal computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) were performed in 1 patient, and magnetic resonance cholangiopancreatography (MRCP) was performed in 2. Etiology was cholelithiasis (2 patients), secondary to anti-oncological therapy (3 patients), hypercholesterolemia (1 patient), and idiopathic (3 patients). Medical treatment consisted of diet, analgesia, and octreotide in 1 patient, and antioxidants in 1 patient. Surgery was required in 2 patients. Complications consisted of pancreatic pseudocyst in 2 patients.
Conclusions: The incidence of childhood pancreatitis is low. In our series, mainly teenage girls were affected. The main causes were idiopathic and toxic. Diagnosis was given by elevated amylase and lipase levels in blood and by imaging tests (ultrasonography, abdominal CT, ERCP, MRCP, depending on the patient). Basic treatment consisted of support measures (fasting and analgesia) together with octreotide, antioxidants or surgical treatment, depending on etiology.