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Pancreatic ascites in children

A J D'Cruz1, P S Kamath, C Ramachandra

  • 1Department of Pediatric Surgery, St John's Medical College Hospital, Bangalore, India.

Acta Paediatrica Japonica : Overseas Edition
|October 1, 1995
PubMed
Summary

Pancreatic ascites in children, a rare condition causing severe malnutrition, can be effectively treated with surgery. Endoscopic retrograde cholangiopancreatography (ERCP) is crucial for diagnosis and surgical planning.

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Area of Science:

  • Pediatric Gastroenterology
  • Surgical Interventions

Background:

  • Pancreatic ascites is a rare but serious complication in children, often presenting with intractable ascites, malnutrition, and significant weight loss.
  • Diagnosis relies on elevated ascitic fluid and serum amylase levels, with endoscopic retrograde cholangiopancreatography (ERCP) essential for identifying pancreatic duct disruption and pseudocysts.

Observation:

  • Three pediatric patients with pancreatic ascites, confirmed via ERCP, underwent surgical management.
  • Surgical approaches included stented transgastric pseudocyst drainage and Roux-en-Y cystojejunostomy, with one case requiring revision surgery for a recurrent pseudocyst.

Findings:

  • All three children achieved complete resolution of ascites and experienced significant improvement in nutritional status post-surgery.
  • Long-term follow-up confirmed sustained pain relief and absence of ascites, indicating successful surgical outcomes.

Implications:

  • Pancreatic ascites should be strongly considered in the differential diagnosis of pediatric ascites.
  • ERCP plays a vital role in the diagnostic and management planning of pancreatic ascites.
  • Cystoenterostomy represents a definitive and effective treatment for pediatric pancreatic ascites, leading to favorable long-term prognoses.

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