Traumatic and non-traumatic pancreatitis in pediatric surgery

Today pancreatitis is classified only as acute or chronic. In pediatric surgery it seems more practical to distinguish traumatic from non-traumatic cases. To show whether there is also a difference in the management of these two groups we analysed all patients treated between 1977 and 1991 for pancreatitis. It was most impressive that traumatic cases were operated on in 86% and the rate of pseudocysts reached 61.5% whereas non-traumatic pancreatitis required surgical intervention in 50% and developed pseudocysts in 17%. Following trauma elevation of serum enzyme concentration lasted longer in a significant number of patients but became normal without any hint of further complications. In non-traumatic pancreatitis it is recommended that surgery should be avoided and reserved for complications. Exceptions are obstructions of the pancreaticobiliary ducts which need early removal to prevent chronicity of the disease and functional loss of the organ.