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Acute pancreatitis in children: risk factors, management, and outcomes
1Division of Pediatric Gastroenterology, UT Southwestern Medical Center, Dallas, Texas, USA.
Insights
Pediatric acute pancreatitis, though rare, can be severe in children. Management focuses on fluids, nutrition, and pain relief, with complications addressed via a step-up approach.
Area of Science:
- Pediatric Gastroenterology
- Pancreatology
Background:
- Pediatric acute pancreatitis is an infrequent but potentially serious condition in children.
- While most cases are mild, up to one-third can develop moderate or severe disease, or progress to chronic pancreatitis.
Conclusions:
- Management includes fluid resuscitation, early enteral nutrition, and pain control.
- Care is largely supportive with a step-up approach for complications.
- Advances in understanding pediatric pancreatitis have improved management and recognition of its unique aspects.
Purpose Of Review:
Pediatric acute pancreatitis is an infrequent but potentially serious condition in children. Most have mild cases with spontaneous resolution, but up to one-third of patients can have moderate or severe disease or progress to recurrent or chronic pancreatitis.
Recent Findings:
Significant advances have been made in the field of pediatric pancreatology with a recognition that pediatric acute pancreatitis can vary significantly from adult disease with different risk factors and outcomes. There is better understanding of appropriate management for pediatric pancreatitis as well as growing literature in complications of pancreatitis.
Summary:
The most common risk factors for pediatric acute pancreatitis include biliary disease, drug/toxin and idiopathic. Management involves adequate fluid resuscitation, early enteral nutrition and appropriate pain control. Systemic and local complications, including SIRS, necrosis and fluid collections, can occur in up to one-third of patients and care is largely supportive with a careful step-up approach to fluid collections and necrosis.
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