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Pancreatitis
Sunday, 15 August 2004
Sunday, 15 August 2004

What

The pancreas is a gland that is part of the digestive system. The pancreas makes and secretes digestive enzymes into the small intestine and releases insulin and glucagon, two hormones that help regulate blood sugar levels. This gland is the key to breaking down food in our bodies. Pancreatitis occurs when the pancreas becomes inflamed. This inflammation can damage the pancreas to a point where it cannot do its job normally. The digestive and hormonal problems associated with pancreatitis can be very serious and actually become life threatening.

Who

Pancreatitis in children is rare. This disease is so uncommon in children that a hospital may only see 1-10 children a year with pancreatitis. When a child does get pancreatitis it is usually related to another disease. It is usually this other disease that causes pancreatitis rather than pancreatitis occurring alone. For example, children with cystic fibrosis can have pancreatitis. Other diseases that can lead to pancreatitis are trauma and congenital heart problems. Only very rarely does a child have pancreatitis due to an unknown reason.

Signs and Symptoms

The most common sign of pancreatitis is severe middle to upper stomach pain. This pain is almost always present with pancreatitis and is frequently described as stabbing pain moving into the back. Other common signs and symptoms of acute pancreatitis include: 1. Vomiting 2. Fever 3. Intensely tender stomach 4. Mass in the stomach 5. Large amounts of fluid in the abdominal cavity, leading to a distended belly 6. Poor appetite 7. Low blood pressure

Possible Causes

One of the main roles of the pancreas is to secrete digestive enzymes to break down food. The pancreas stores enzymes in a special way so that they do not digest the pancreas itself. However, when the pancreas becomes inflamed, its own enzymes are released into the blood and within the pancreas itself. This release of enzymes into the pancreas causes damage which leads to further inflammation and more damage. Over a long period of time this can lead to scarring and permanent damage to the pancreas. The most common causes of acute pancreatitis in a child is trauma to the abdomen, drug overdose, side effect of some medications, or abnormal formation of the pancreas before birth. There are some rare cases of pancreatitis where the cause is unknown.

Diagnosis

The diagnosis of pancreatitis is made from physical examination and blood tests for elevations of the enzymes amylase and lipase enzymes (main pancreatic enzymes). A positive test for elevated enzymes is what first leads to the suspicion of pancreatitis as the cause of severe stomach pain. An ultrasound and/or CT scan may be performed to see if there is an enlarged pancreas, infection or swelling.

Treatment

The treatment of pancreatitis involves pain management, resting the pancreas and providing the body nutritional support. Pancreatitis can be very painful and this is treated with pain medication. Pancreatic secretions should be minimized so the pancreas does not continue to destroy itself. This is accomplished by having a very strict diet of foods that do not stimulate the pancreas and/or using a feeding tube to bypass the pancreas in the digestive process. Lastly, the patient is treated for shock and electrolyte imbalances due to pancreas malfunction. This involves replenishing fluids by IVs and giving drugs that replace the hormones made by the pancreas.

Prognosis

Pancreatitis is a very serious disease that can be life threatening. However, children usually do much better than adults with this disease. In children, pancreatitis is usually related to another disease and in this case the prognosis depends on the prognosis of the primary disease.

Connect with other parents

In the spirit of community and support, Madisons Foundation offers the unique service of connecting parents of children with rare diseases. If you would like to be connected to other parents of children with this disease, please fill out this brief form.

Weblinks

National Pancreas Foundation
Non-profit organization that supports research of pancreatic diseases, along with providing information and humanitarian services to patients and families suffering from a pancreatic disease.

Pancreatitis Association International
Organization dedicated to the support, education, and advocacy of anyone whose life has been affected by the disease of pancreatitis. Website provides online chat rooms along with information about getting involved in special projects that benefit pancreatitis.

Pancreas.org
Great website for information about research, clinical trials, advocacy groups, and support groups.

Google Search for Pancreatitis

References and Sources

Carpenter, C. (2001) Cecil Essentials of Medicine. P. 636-640 Kumar, V. (2003) Robbins Basic Pathology. P. 618, 458-461 www.sma.org.sg/smj/4409/4409a2.pdf www.pancreasweb.com/abstracts/pdf/0001080.pdf www.cureresearch.com/p/pancreatitis/intro.htm