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Pancreatitis associated with remote traumatic brain injury in children
M Urban1, M Splaingard, S L Werlin
1Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee 53226.
Insights
Pancreatitis can occur in children after brain injury, even when symptoms are mild. This previously unreported association suggests pancreatitis should be considered when children show gastrointestinal issues post-brain injury.
Area of Science:
- Pediatric neurology
- Gastroenterology
- Critical care medicine
Background:
- Gastrointestinal symptoms like vomiting and feeding intolerance are common after pediatric brain injury.
- These symptoms are often attributed to the brain injury itself or delayed gastric emptying.
- A specific underlying cause for these symptoms is frequently not investigated.
Observation:
- A cohort of six children experienced mild to moderate pancreatitis at least seven days post-brain injury.
- This pancreatitis developed following apparently isolated brain injuries.
- This association between brain injury and pancreatitis has not been previously reported.
Findings:
- Five of the six patients had received medications known or suspected to cause pancreatitis.
- All patients recovered from pancreatitis without requiring changes to their medication regimens.
- Pancreatitis should be suspected in children presenting with feeding intolerance or upper gastrointestinal distress after traumatic brain injury.
Implications:
- Highlights a potential, previously unrecognized complication of pediatric brain injury.
- Suggests a need for increased vigilance and diagnostic consideration for pancreatitis in this patient population.
- May inform clinical management protocols for children with brain injuries experiencing gastrointestinal disturbances.
Abstract:
Vomiting, abdominal distension, and feeding intolerance are common findings following brain injury in children, and are usually attributed to the brain injury or to delayed gastric emptying: a specific cause is usually not sought. We report six children who developed mild to moderate pancreatitis at least 7 days following apparently isolated brain injury, a previously unreported association. Five of the six patients received drugs that are known or suspected pancreatotoxins; all recovered without changes in the medications. When children develop feeding intolerance or upper gastrointestinal symptoms following traumatic brain injury pancreatitis should be suspected.