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The leaking pancreatic duct in childhood chronic pancreatitis

Dhruva Nath Ghosh1, Sudipta Sen, Jacob Chacko

  • 1Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu 632004, India.

Pediatric Surgery International
|September 27, 2006
PubMed

Insights

Leaking pancreatic ducts in children with chronic pancreatitis can cause ascites and pleural effusion. Prompt surgical intervention, particularly the Puestow

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Gastroenterology
  • Pancreatic Diseases

Background:

  • Childhood chronic pancreatitis can manifest with potentially lethal complications like ascites and pleural effusion due to pancreatic duct leakage.
  • Diagnosis is often delayed, requiring specific biochemical and imaging markers.

Purpose of the Study:

  • To highlight the diagnostic challenges and effective management strategies for pancreatic duct leaks in children with chronic pancreatitis.
  • To emphasize the importance of timely surgical intervention.

Main Methods:

  • Retrospective review of seven pediatric cases diagnosed with pancreatic duct leaks between 2003-2006.
  • Diagnostic methods included serum amylase levels, fluid analysis, and computerized tomography (CT) scans.
  • Surgical interventions included Puestow's procedure and peripancreatic drainage.

Main Results:

  • Diagnosis was confirmed by elevated amylase in ascites/pleural fluid; CT scans revealed dilated pancreatic ducts.
  • Six out of seven children underwent Puestow's procedure, achieving prompt and lasting recovery.
  • One child with comorbid metastatic neuroblastoma died postoperatively after peripancreatic drainage.

Conclusions:

  • Pancreatic duct leaks in childhood chronic pancreatitis are serious but manageable with prompt surgical treatment.
  • The Puestow's procedure demonstrated high efficacy in achieving recovery.
  • Early surgical intervention is crucial for improving outcomes in this pediatric condition.

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