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Pediatric Acute Recurrent and Chronic Pancreatitis

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The pancreas is a large organ in the upper abdomen. It releases enzymes that help in the digestion of food and also releases insulin and glucagon to control how the body uses food for energy.

Acute pancreatitis means there is inflammation of the pancreas. It may range from feelings of mild discomfort to a major, life-threatening illness. Most children recover completely after treatment.

Chronic pancreatitis is inflammation of the pancreas that does not heal, or gets worse over time. It can lead to permanent damage.

Our nationally recognized gastroenterology team supports your child through every step of treatment. We are with you from initial evaluation through ongoing assistance with recovery after surgery or hospitalization, if needed.

Why Children's Health℠?

The Division of Gastroenterology, Hepatology and Nutrition at Children’s Health and UTSW are innovators in the care of digestive and nutritional conditions in infants, children and adolescents. We are ranked by U.S. News and World Report magazine as one of the top programs of its type in the nation. Children’s Health routinely delivers world-class care to 2,000 patients per month, including children from surrounding communities and states.

We use a multidisciplinary approach to treating pancreatic diseases in children. In addition to gastroenterologists who are all board certified by the American Board of Pediatrics, other professionals on our team include geneticists, nutritionists, radiologists, and surgeons. 

The physicians who practice at Children’s Health are faculty members at the UT Southwestern Medical Center. This means that in addition to keeping up with all the newest treatments in gastroenterology, they are actively helping develop the next generation of interventions for pancreatic disease.

Should your child require hospitalization, our highly trained and professional nursing staff is one of the reasons Children’s Health has been designated as a Magnet Hospital by the American Nurses Credentialing Center. Being a Magnet Hospital puts us in the top 7% of the world’s hospitals and is a reflection of the excellence of our nursing staff. 

What is the Pancreas?

The pancreas is an organ about 6 inches long, located behind the stomach and near the small intestine. It has two major jobs in the body.

Perhaps the most important is performed by islets of Langerhans, where the pancreas makes and releases hormones such as insulin and glucagon. They work to maintain sugar levels, with the glucagon breaking down unprocessed sugars in the liver; insulin then appears at the site of the individual cells to help them absorb these sugars and convert them to energy.

The other function is performed by cells known as the pancreatic acinar cells, which make and secrete the pancreatic enzymes and bicarbonate ions that helps digest fat, protein, and carbohydrates. They include lipase for fat digestion, trypsin that works to digest protein, and amylase, which breaks down starches and converts them to sugar.

Medical Treatment

The treatment your child undergoes will depend on how severe the pancreatitis is. If there are no other organs involved, no severe infections occurring, and the enzymes of the pancreas aren’t causing a hole, acute pancreatitis usually improves on its own. Treatment, in general, is designed to support vital bodily functions and prevent complications.

For many children, treatment will focus on the symptoms – for example, medicine might be given to help with nausea or vomiting. The doctor may also prescribe pain relievers to help make your child more comfortable. A large percentage of kids can be successfully treated this way and the pancreatitis goes away after a week or so.

Sometimes your child will need to be admitted to the hospital so that the fluids they lose can be replaced intravenously. 

The doctor will try to determine what caused it in order to prevent future attacks. In some children, the cause of the attack is clear, but in others, more tests are needed.

The treatment for chronic pancreatitis may be the same as the treatment for acute pancreatitis, especially in the early stages. If the doctors find something abnormal in the structure of your child’s pancreas, then endoscopic treatment surgery may cure the problem.

For those with a high serum calcium or serum fat (triglycerides), this can also be treated. Your doctor may prescribe medications or recommend changes in diet to reverse these elevated levels. Physicians may prescribe pills containing pancreatic digestive enzymes to patients who experience chronic pain.  It is also possible that your child will benefit from an advanced endoscopic procedure known as ERCP. 

Surgery

Most often, acute pancreatitis in children is managed without surgery. For children with chronic pancreatitis, the likelihood of surgery is increased. When surgery is required, the staff at Children’s Health is uniquely qualified to give your child the best care possible.

The physicians who practice at Children’s Health perform over 4,000 surgeries annually, making Children’s Health℠ one of the largest providers of pediatric surgery in North Texas. Each member of our team is board certified by the American Board of Surgery.

We are able to bring the latest in minimally-invasive surgical techniques to the treatment of your child’s pancreatitis. This means the incision is smaller with a shorter recovery time, less scarring, less pain and stress afterwards. The specific kind of surgery to be used for your child will be discussed with you by the surgeon.

To help alleviate the fear of surgery, our child life specialists conduct medical child play therapy with patients before surgery and provide parents and patients an opportunity to ask questions about the surgery.