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Management of acute pancreatitis in children
Maisam Abu-El-Haija1, Tom K Lin, Jaimie D Nathan
1aDivision of Pediatric Gastroenterology, Hepatology and Nutrition bDivision of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Insights
Pediatric acute pancreatitis is increasing, with outcomes differing from adults. While supportive care is key, severe cases may need interventions like drainage or surgery.
Area of Science:
- Pediatric Gastroenterology
- Pancreatology
Background:
- Pediatric acute pancreatitis incidence is rising, nearing adult levels.
- It's a distinct entity from adult pancreatitis due to differing causes and outcomes.
- While often self-limiting, a subset progresses to severe disease with significant morbidity and mortality.
Purpose of the Study:
- To review the current understanding and management of pediatric acute pancreatitis.
- To highlight advances in medical, interventional, and surgical approaches.
- To differentiate pediatric acute pancreatitis from its adult counterpart.
Main Methods:
- Review of recent literature on pediatric acute pancreatitis.
- Analysis of current management strategies.
- Comparison of pediatric and adult pancreatitis characteristics.
Main Results:
- Supportive care (fluids, analgesia, nutrition) is the primary treatment.
- Severe or complicated cases may necessitate endoscopic or drainage procedures.
- Surgery plays a limited but important role in select pediatric cases.
Conclusions:
- Pediatric acute pancreatitis requires tailored management distinct from adults.
- Advances in understanding are improving care for children.
- Multidisciplinary approaches are crucial for optimal outcomes.
Purpose Of Review:
Pediatric acute pancreatitis has been on the rise in the last decades, with an incidence close to adult pancreatitis. In the majority of cases acute pancreatitis resolves spontaneously, but in a subset of children the disease progresses to severe acute pancreatitis with attendant morbidity and mortality.
Recent Findings:
Pediatric acute pancreatitis in this era is recognized as a separate entity from adult acute pancreatitis given that the causes and disease outcomes are different. There are slow but important advances made in understanding the best management for acute pancreatitis in children from medical, interventional, and surgical aspects.
Summary:
Supportive care with fluids, pain medications, and nutrition remain the mainstay for acute pancreatitis management. For complicated or severe pancreatitis, specialized interventions may be required with endoscopic or drainage procedures. Surgery has an important but limited role in pediatric acute pancreatitis.
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Assessment:
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