Pancreatitis in children: diagnosis and etiology in 57 patients

Pancreatitis in children is uncommon, but can be the cause of significant morbidity. We undertook this study to review recent changes in the management of pediatric pancreatitis. Between 1974 and 1992, 57 cases of pancreatitis in children up to 19 years of age were treated at our institution. The etiologies were quite diverse and included idiopathic, traumatic, drug-related, biliary, congenital, and alcoholic causes. The diagnosis of pancreatitis was made from the clinical presentation and laboratory values in most cases. Serum amylase was elevated in the majority of children. Further diagnostic evaluations included abdominal ultrasound, computed tomography, and endoscopic retrograde cholangiopancreatography. Pseudocyst development was the most common complication, especially in those cases associated with trauma. In contrast to adults with pancreatitis, who usually respond to nonoperative therapy, only 32 of the 57 children responded to nonoperative treatment. The most common long-term morbidity was recurrent pancreatitis; however, the majority of patients suffered no long-term sequelae of their pancreatitis or its treatment.