Pancreatitis - children
Pancreatitis in children, as in adults, occurs when the pancreas becomes swollen and inflamed.
Causes
The pancreas is an organ behind the stomach.
It produces chemicals called enzymes, which are needed to digest food. Most of the time, the enzymes are only active after they reach the small intestine.
When these enzymes become active inside the pancreas, they digest the tissue of the pancreas. This causes swelling, bleeding and damage to the organ and its blood vessels. This condition is called pancreatitis.
Common causes of pancreatitis in children include:
- Trauma to the belly, such as from a bicycle handlebar injury
- Blocked bile duct
-
Side effects of medicine, such as anti-seizure medicines, chemotherapy, or some antibiotics
Side effects
An overdose is when you take more than the recommended amount of something, often a medicine or drug. An overdose may result in serious, harmful sym...
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Mumps
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Triglycerides
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Other causes include:
- After an organ or bone marrow transplant
-
Cystic fibrosis
Cystic fibrosis
Cystic fibrosis is a disease that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body. It is one of th...
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Immune system
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-
Overactive parathyroid gland
Overactive parathyroid gland
Hyperparathyroidism is a disorder in which 1 or more of the parathyroid glands in your neck produce too much parathyroid hormone (PTH).
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Kawasaki disease
Kawasaki disease
Kawasaki disease is a rare condition that involves inflammation of the blood vessels. It occurs in children.
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Sometimes, the cause is unknown.
Symptoms
The main symptom of pancreatitis in children is severe pain in the upper abdomen. Sometimes the pain may spread to the back, lower abdomen, and front part of the chest. The pain may increase after meals.
Other symptoms may include:
- Cough
- Nausea and vomiting
- Swelling in the abdomen
- Fever
- Yellowing of the skin, called jaundice
Jaundice
Jaundice is a yellow color of the skin, mucus membranes, or eyes. The yellow coloring comes from bilirubin, a byproduct of old red blood cells. Jau...
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- Increased pulse
Exams and Tests
Your child's health care provider will do a physical exam, which may show:
- Abdominal tenderness or lump (mass)
- Fever
-
Low blood pressure
Low blood pressure
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- Fast breathing rate
The provider will perform lab tests to check the release of pancreatic enzymes. These include tests to check the:
-
Blood amylase level
Blood amylase level
Amylase is an enzyme that helps digest carbohydrates. It is made primarily in the pancreas and the glands that make saliva, and can be found at low ...
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Blood lipase level
Blood lipase level
Lipase is a protein (enzyme) released by the pancreas into the small intestine. It helps the body absorb fat. This test is used to measure the amou...
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Other blood tests include:
-
Complete blood count (CBC)
Complete blood count (CBC)
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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Blood tests that provide an overall pic...
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Imaging tests that can show inflammation of the pancreas include:
-
Ultrasound of the abdomen (most common)
Ultrasound of the abdomen
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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CT scan of the abdomen
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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MRI of the abdomen
MRI of the abdomen
An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...
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Treatment
Treatment may require a stay in the hospital. It may involve:
- Pain medicines
- Stopping food or fluids by mouth
- Fluids given through a vein (IV)
- Anti-nausea medicines for nausea and vomiting
- Low-fat diet
The provider may insert a tube through the child's nose or mouth to remove contents of the stomach. The tube will be left in for one or more days. This may be done if vomiting and severe pain don't improve. The child also may be given food through a vein (IV) or a feeding tube.
The child can be given solid food once they stop vomiting. Most children are able to take solid food within 1 or 2 days after an attack of acute pancreatitis.
In some cases, therapy is needed to:
- Drain fluid that has collected in or around the pancreas
- Remove gallstones
Gallstones
Gallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.
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Outlook (Prognosis)
Most cases go away in a week. Children usually recover completely.
Chronic pancreatitis is rarely seen in children. When it occurs, it is most often due to genetic defects or birth defects of the pancreas or biliary ducts.
Possible Complications
Severe irritation of the pancreas, and pancreatitis due to blunt trauma, such as from a bike handle bar, can cause complications. These may include:
- Collection of fluid around the pancreas
Pancreas
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Ascites
Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
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When to Contact a Medical Professional
Call the provider if your child shows symptoms of pancreatitis. Also call if your child has these symptoms:
- Intense, constant abdominal pain
- Develops other symptoms of acute pancreatitis
- Severe upper abdominal pain and vomiting
Prevention
Most of the time, there is no way to prevent pancreatitis.
References
Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Pancreatitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 378.
Schaffzin JK. Acute pancreatitis. In: Long SS, ed. Principles and Practice of Pediatric Infectious Diseases. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 62.
Vitale DS, Abu-El-Haija M. Pancreatitis. In: Wyllie R, Hyams JS, Kay M, eds. Pediatric Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: Elsevier; 2021:chap 82.
Review Date: 5/6/2022
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.