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Acute gallstone pancreatitis in childhood
1Department of Surgery, The Luton and Dunstable Hospital, Luton, Bedfordshire, UK.
Insights
Acute pancreatitis in children is often misdiagnosed. Early investigation of gallstone disease is crucial to prevent serious complications like jaundice.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Surgical Gastroenterology
Background:
- Acute pancreatitis is infrequently diagnosed in pediatric patients with abdominal pain.
- Gallstones are an uncommon cause of pancreatitis in children, with trauma, infections, and idiopathic factors being more frequent.
- Delayed diagnosis of gallstone disease can lead to severe complications.
Observation:
- Three pediatric cases of acute pancreatitis and jaundice caused by gallstones are presented.
- These cases resolved with conservative management, followed by laparoscopic cholecystectomy and, in some cases, ERCP.
- All three children had prior undiagnosed symptoms suggestive of gallstone disease.
Findings:
- Gallstone-induced acute pancreatitis can occur in children and may present with jaundice.
- Conservative treatment can be effective for acute gallstone pancreatitis in pediatric patients.
- Laparoscopic cholecystectomy, with or without ERCP, is a viable management strategy for pediatric gallstones.
Implications:
- Pediatric acute pancreatitis warrants consideration in emergency abdominal pain evaluations.
- Investigating recurrent upper abdominal pain for gallstone disease is essential in children.
- Timely diagnosis and management of pediatric gallstone disease can prevent severe outcomes like acute pancreatitis and jaundice.
Abstract:
Acute pancreatitis is rarely considered in the diagnosis of paediatric abdominal pain and can be misdiagnosed. Gallstones are uncommon in children and are a rare cause of pancreatitis. Trauma, infections and idiopathic causes are the commonest aetiological factors. Three cases of gallstone-induced acute pancreatitis with jaundice in children are reported which resolved with conservative treatment. The gallstones were managed by laparoscopic cholecystectomy with or without endoscopic retrograde cholangiopancreatography (ERCP). The three children had presented previously to a doctor with symptoms of gallstone disease but the diagnosis was missed. It is concluded that acute pancreatitis should be considered in children presenting as an emergency with abdominal pain. Children with recurrent attacks of upper abdominal pain should be investigated for gallstone disease so that the diagnosis is made before the development of potentially serious complications such as acute pancreatitis and jaundice.