Abstract
Ninety children treated for acute, relapsing, or chronic pancreatitis at the Red Cross War Memorial Children's Hospital, Cape Town, between 1958 and 1982 are reviewed. The commonest cause was Ascaris worms in the bile duct and the next commonest identifiable cause was trauma. Diagnosis was clinical, confirmed by raised amylase levels and radiological or operative findings. Ultrasound was particularly helpful. Treatment was initially non-operative but operations were done in 33 patients because of complications or diagnostic doubt. Pseudocyst formation was the commonest complication (20 patients) and 40% of pseudocysts resolved without treatment within 3 weeks. The remainder were drained, mostly by cyst-gastrostomy, but 3 were successfully drained externally. The long-term outcome was satisfactory in 90% of patients; 1 child developed insulin-dependent diabetes and only 2 died (3.3% mortality). We consider that pancreatitis is probably underdiagnosed in children; many cases are relatively mild. Our patients had a low mortality compared with other series containing a higher proportion of immunocompromised patients on corticosteroid and cytotoxic drug therapy.
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Bradley EL, Clements JL, Gonzales AC (1979) The natural history of pancreatic pseudocysts. Am J Surg 137: 135–141
Buntain WL, Wood JB, Woolley MM (1978) Pancreatitis in Childhood. J Pediatr Surg 13: 143–149
Collins J (1958) Pancreatitis in young children. Arch Dis Child 33: 432–436
Comfort MW, Steinberg AG (1952) Pedigree of a family with hereditary chronic relapsing pancreatitis. Gastroenterology 21: 54
Cooney DR, Grosfeld JL (1975) Operative management of pancreatic pseudocysts in infants and children. A review of 75 cases. Ann Surg 182: 590–596
Cooperman AM (1981) Chronic pancreatitis. Surg Clin North Am 61: 71–83
Cotton PB, Denyer ME, Kreel L, Husband J, Meire HB, Lees W (1978) Comparative clinical impact of endoscopic pancreatography, grey scale ultrasonography and computed tomography (EMI scanning) in pancreatic disease: preliminary report. Gut 19: 679–684
Cremin BJ (1982) Ultrasonic diagnosis of biliary ascariasis. Br J Radiol 55: 683–684
Gaskin K, Gurwitz D, Durie P, Corey M, Levison H, Forstner G (1982) Improved respiratory prognosis in patients with cystic fibrosis with normal fat absorption. J Pediatr 100: 857–862
Karlson KB, Martin EC, Fankuchen EI, Mattern RF, Shultz RW, Casarella WJ (1982) Percutaneous drainage of pancreatic pseudocysts and abscesses. Diagn Radiol 142: 619–624
Louw JH (1974) Biliary ascariasis in childhood. S Afr J Surg 12: 219–225
Louw JH, Marks IN, Banks S (1967) The management of severe acute pancreatitis. Postgrad Med J 43: 31–44
Mallory A, Kern F (1980) Drug-induced pancreatitis, a critical review. Gastroenterology 78: 813–820
Matsusue S, Kashihara S, Nakamura Y, Masumoto H (1982) Role of unusually long common pancreatico-biliary channel as a cause of relapsing pancreatitis in children. Z Kinderchir 36: 69–72
Meire HB, Farrant P (1979) Pancreatic ultrasound — a systematic approach to scanning technique. Br J Radiol 52: 562–567
Murray WR, MacKay C (1977) The amylase-creatinine clearance ratio in acute pancreatitis. Br J Surg 64: 189–191
Ranson JHC, Rifkind KM, Turner JW (1974) Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 139: 69–81
Ranson JHC, Rifkind KM, Turner JW (1976) Prognostic signs and peritoneal lavage in acute pancreatitis. Surg Gynecol Obstet 143: 209–219
Sarles H, Sarles JC, Camatte R, Muratore R, Gaini M, Guien C, Pastor J, LeRoy F (1965) Observations on 205 confirmed cases of acute pancreatitis, recurring pancreatitis and chronic pancreatitis. Gut 6: 545–559
Schmidt BJ, Barros Barreto HP, Barbante PJ, Ramos OL, Concone MCMP, Queiroz AS, Carvalho AA (1964) Pancreatic lithiasis due to malnutrition and alcoholism in a child. J Pediatr 65: 613–615
Sibert JR (1976) In: Topics in paediatric gastroenterology. Pitman Medical Montreal pp 173–181
Stein D (1963) Pancreatitis — acute and relapsing — in infancy and childhood. S Afr Med J 37: 1006–1072
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Spicer, R.D., Cywes, S. Pancreatitis in childhood. Pediatr Surg Int 3, 33–36 (1988). https://doi.org/10.1007/BF00177077
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DOI: https://doi.org/10.1007/BF00177077