What is Acute Pancreatitis?
Acute pancreatitis is inflammation of the pancreas that occurs suddenly. It can last for a couple of days or, if complications occur, several weeks.
What Does the Pancreas Do?
The pancreas is a large gland behind the stomach. It makes enzymes that help digest food, and secretes insulin and glucagon, two hormones that help control blood sugar, the body’s main source of energy.
How Common is Acute Pancreatitis?
Acute pancreatitis strikes about one in 10,000 children in America each year. One out of three cases is severe, and the inflammation affects other organs in the body. In rare cases, recurrent episodes of acute pancreatitis lead to chronic pancreatitis, which causes permanent damage to the pancreas over time.
What Causes Acute Pancreatitis?
Causes of acute pancreatitis may include:
- Trauma to the pancreas (such as a strong blow to the belly)
- Another disease, such as systemic illnesses
- Genetics or heredity
- An infection
- A stone or ductal anomaly
In some cases, however, the cause of acute pancreatitis is not known.
Signs and Symptoms
Acute pancreatitis usually goes away quickly, within a week. But it is important to recognize the symptoms early and seek medical care in order to lessen the risk of complications.
The most common symptom of acute pancreatitis is intense upper abdominal pain. This pain usually is much more painful than a typical bellyache. It can be constant, come and go unpredictably, and worsen after eating. A child may describe it as severe, or have trouble standing or sitting upright.
Other symptoms include:
- A swollen, tender belly (abdomen)
- Back pain
- Loss of appetite
- Fast heartbeat
If you suspect your child is experiencing pancreatitis, call your child’s primary care doctor or go to a nearby urgent care center or emergency department for help.
Problems Associated with Acute Pancreatitis
Complications of acute pancreatitis can happen in some patients, and can include:
- Dehydration and low blood pressure
- Pseudocysts (fluid-filled cavities) in the pancreas, which can cause vomiting and fever
- Damage to other organs, including the heart, lungs and kidneys
Diagnosing Acute Pancreatitis
Symptoms of acute pancreatitis can be similar to those of other illnesses, making a diagnosis is often a challenge. Sometimes, pancreatitis is misdiagnosed as constipation, irritable bowel syndrome or heartburn.
To diagnose acute pancreatitis, a physician will perform a thorough physical exam and ask questions about the child’s medical history. The doctor may order:
- Blood tests to check to see how well the pancreas is working
- Tests that take images, or pictures of the pancreas
- An ultrasound
- A CT scan to check for signs of damage to the pancreas.
- A MRI (magnetic resonance imaging), to check for abnormalities in the pancreatic duct
- Endoscopic retrograde cholangiopancreatography (ERCP), to look at small intestine, pancreatic duct and other parts of the gastrointestinal tract
- Genetic tests to look for possible hereditary cause
Treating Acute Pancreatitis
Treatment for acute pancreatitis depends on the severity of a child’s symptoms. Children with mild cases recover on their own with minimal medical support in the hospital.
Severe cases require a hospital stay with close monitoring. During a hospital stay, treatment involves:
- Managing the child’s pain
- Providing IV (intravenous) fluids to keep the child hydrated
- Nutritional therapies that are likely to promote proper healing
After returning home, your child may need to follow a special diet until enzyme levels return to normal. The doctor will want to see your child for a follow-up visit, and may order a blood test to evaluate enzyme levels.
Outlook for People with Acute Pancreatitis
Most children who develop acute pancreatitis recover within a week, and have few or no complications.
In most cases, acute pancreatitis does not recur. Fifteen percent to 30 percent of the time, another episode occurs, and doctors will order more tests to identify the cause and help decide the best treatment.