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  1. Home
  3. Management Of Fibrosing Pancreatitis In Children Presenting With Obstructive Jaundice
  1. Home
  3. Management Of Fibrosing Pancreatitis In Children Presenting With Obstructive Jaundice

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Management of fibrosing pancreatitis in children presenting with obstructive jaundice

F A Sylvester1, B Shuckett, E Cutz

  • 1Division of Gastroenterology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.

Gut
|November 21, 1998

View abstract on PubMed

Summary
This summary is machine-generated.

Non-surgical temporary drainage for pediatric fibrosing pancreatitis can relieve bile duct obstruction. However, pancreatic function often deteriorates, leading to insufficiency, necessitating close monitoring before surgical intervention.

Related Experiment Videos

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Surgical Gastroenterology

Background:

  • Fibrosing pancreatitis in children typically requires surgery for common bile duct (CBD) obstruction.
  • Pancreatic function post-obstruction resolution has not been extensively studied in pediatric cases.

Observation:

  • Four children (1.5-13 years) with fibrosing pancreatitis presented with CBD obstruction due to pancreatic head enlargement.
  • Biopsies revealed acinar atrophy and fibrosis; parvovirus B19 was identified in one case.
  • Temporary CBD drainage was performed in three patients, with one undergoing choledochojejunostomy.

Findings:

  • CBD obstruction and pancreatic enlargement resolved after drainage procedures.
  • Exocrine pancreatic function significantly deteriorated in three patients, leading to insufficiency within 2-4 months.
  • One patient maintained pancreatic sufficiency despite diminished function; no cases of diabetes mellitus were observed.

Implications:

  • Non-surgical temporary drainage is a viable initial approach for pediatric fibrosing pancreatitis with CBD obstruction.
  • Close monitoring of exocrine pancreatic function is crucial post-drainage due to the high risk of insufficiency.
  • This approach may help defer or avoid surgery, but requires careful follow-up to manage potential pancreatic insufficiency.