Pancreatitis

The pancreas is responsible for making the body’s digestive enzymes that help break down proteins, sugars and fats from the food we eat. Pancreatitis is a condition in which the pancreas is damaged or inflamed. The board-certified pediatric gastroenterologists with Norton Children’s Gastroenterology, affiliated with the UofL School of Medicine, provide specialized care for children and teens with pancreatitis.

What Is Pancreatitis?

Pancreatitis in children can be chronic or acute. Acute pancreatitis is when the pancreas is damaged or inflamed; this can happen once, or a child can have multiple episodes of acute pancreatitis. Chronic pancreatitis is a condition in which there is permanent damage to pancreas function after several episodes of acute pancreatitis.

What Causes Pancreatitis in Children?

There are many causes of pancreatitis, but in as many as 30% of cases, no cause can be identified. Some causes can include:

  • An injury to the abdomen, such as a bicycle or sports-related injury
  • Antiseizure medicines
  • Certain antibiotics
  • Certain kinds of chemotherapy
  • Gallstones
  • High levels of triglycerides (fat) in the blood
  • Immune system conditions
  • Infection
  • Overactive parathyroid gland

Pancreatitis can be related to other chronic conditions, including inflammatory bowel disease (IBD), cystic fibrosis or celiac disease.

Acute Pancreatitis Symptoms

A child experiencing acute pancreatitis symptoms should get medical attention immediately. It usually requires hospitalization with close monitoring. Symptoms can include:

  • Abdominal (belly) pain
  • Difficulty breathing
  • Fever
  • Nausea
  • Vomiting

Chronic Pancreatitis Symptoms

Upper abdomen pain and discomfort is one of the most common symptoms of chronic pancreatitis. The pain may extend into the back. The pain can last hours or days, and could be constant or feel like it switches off and on. The pain can increase after eating or drinking. Other symptoms can include:

  • Weight loss, even when eating habits and diet are normal
  • Oily stool
  • Nausea
  • Vomiting
  • Diarrhea

Pancreatitis Treatment

Care for pancreatitis will be unique to the child’s age and current condition. The goal of treatment is to support the body’s normal function. Treatment for acute pancreatitis may include:

  • Medicines to help with pain
  • Antinausea medicines
  • Fluids through an IV to keep the body hydrated
  • Liquid nutrition (for children unable to eat for several days)

There are no specific medications or cures for chronic pancreatitis. Treatment for chronic pancreatitis may include:

  • Medicines to ease pain
  • Pancreatic enzyme treatment to help with digestion
  • Insulin may be needed to help control blood sugar level

Children with severe chronic pancreatitis and pain may need surgery. Surgical options for severe chronic pancreatitis may include:

  • Lateral pancreaticojejunostomy (Puestow procedure): This procedure connects a segment of the small intestine to the pancreas to improve drainage from the primary pancreatic duct.
  • Total pancreatectomy with islet autotransplantation (TPIAT): In this procedure, the pancreas is partially or completely removed. Then, the hormone-producing cells (islets) are found within the pancreas and isolated in a laboratory. The islets are then injected into the patient’s liver. The goal is for the transplanted islets to begin producing insulin in the liver, lessening a patient’s chance of developing diabetes. The damaged portion of the pancreas is discarded.

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