Introduction: To determine the profile of Pancreatic disorders in children (age <16 yrs) presenting to a tertiary health care centre in North India.
Methods: 68 children (<16 yrs) presenting to the pediatric medical services of the hospital with pancreatic disorders were recruited in the study from Oct. 1998 to Nov. 2003. The mean age was 10.2 yrs (range 0.5–16 yrs) with male: female ratio of 38: 30.
Results: There were 27 patients of acute pancreatitis and 24 cases of chronic pancreatitis. 14 patients had recurrent pancreatitis while 3 cases were of cystic fibrosis with pancreatic insufficiency. Etiology of acute pancreatitis which could be identified in 17(62.9%) included traumatic 6 (22.2%), biliary 4(14.8%), mumps 4 (14.8%), and hepatitis A in 11.1%. Complications were seen in 14 patients (51.8%) in the form of pseudocyst 10 (37%), necrosis 6 (22.2%),haemorrhage 4 (14.8%), infection 2 (7.4%), seizures & acute renal failure in one each. There were no deaths. The etiology in most of the cases of recurrent pancreatitis was idiopathic 8 (57.1%),while there was one case each of gallstones, choledochal cyst, anomalous pancreatico biliary junction and hyperparathyroidism with hypercalcemia. 2 cases had family history of more than 2 family members suffering from pancreatitis. Out of 24 patients of chronic pancreatitis, 11(45.8%) were of calcific variety while the rest 54.1% were non-calcific. Complications were seen in 13 (54.1%) in the form of pseudocyst 7(29.1%), stricture of the pancreatic duct 6(25%), atrophy of the gland 2(8.3%), gastroduodenal artery aneurysm and compartmental portal hypertension in one case, exocrine pancreatic insufficiency and diabetes mellitus in one each.
Conclusion: Pancreatic disorders in children require a high degree of clinical suspicion. Traumatic pancreatitis was the commonest cause of acute pancreatitis next to idiopathic. Complications were seen in 51.8% of acute pancreatitis patients with pseu-docyst in 37% & necrosis in 22.2%,with no mortality. 54.1% of chronic pancreatitis cases had complications with pseudocyst in 29.1% and stricture of pancreatic duct in 25%. Chronic non calcific variety (54.1%) was slightly more common than calcific variety and diabetes mellitus / steatorrhoea have been uncommon in North Indian children.