PEDIATRICS Vol. 19 No. 6 June 1957, pp. 1002-1010
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ACUTE PANCREATITIS IN CHILDREN

David A. Blumenstock M.D.1, James Mithoefer M.D.1, and Thomas V. Santulli M.D.1

1 Department of Surgery, College of Physicians and Surgeons, Columbia University, and the Surgical Services of the Babies and Presbyterian Hospitals, New York City, and the Surgical Service of the Mary Imogene Bassett Hospital, Cooperstown, New York

Four cases of acute pancreatitis in children are presented. Thirty-six cases reported in the literature are briefly reviewed.

The diagnosis of acute pancreatitis is rarely made in children before operation or necropsy because the disease is confused with the more frequent causes of abdominal pain and vomiting in this age group. However, the clinical history and abdominal signs may be suggestive of acute pancreatitis. The diagnosis can be confirmed by demonstrating elevation of the concentration of amylase in the serum, provided mumps is not present.

In contrast to adult patients, acute pancreatitis in children is seldom related to disease of the biliary system.

Acute pancreatitis in children may be produced by trauma, acute infection and mechanical obstruction of the pancreatic ducts by round worms. The etiology of the majority of cases, however, remains unknown.

The complications of acute pancreatitis in children include diabetes mellitus, retroperitoneal hemorrhage, pseudocyst formation and hypocalcemic tetany.

Treatment of uncomplicated acute pancreatitis should be conservative if the diagnosis can be made without operation.

Submitted on August 15, 1956
Accepted on November 14, 1956




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