What happens to the gland
The pancreas produces enzymes that normally become active only in the intestines. When exposed to unfavorable factors, the outflow of pancreatic juice is disrupted, the gland swells, and some enzymes begin to act in the tissue itself. In children, this process is usually limited and reversible, which is why they talk about a reactive state, and not about the destruction of the gland. It is provoked by viral and intestinal infections, rich fatty foods, carbonated drinks, some medications, diseases of the gallbladder and duodenum, and abdominal trauma.
- Swelling of the gland and impaired outflow of juice
- Intestinal and viral infections
- Large fatty and fried foods
- Taking certain medications
- Diseases of the biliary tract and stomach
- Blunt abdominal trauma
How it manifests itself
The leading complaint is pain in the upper abdomen or around the navel, which can radiate to the back and worsen after eating. The child becomes lethargic, refuses to eat, complains of nausea, vomiting, bloating and loose stools are possible. The temperature is often low or normal. Small children cannot pinpoint the exact location of the pain: they cry, pull up their legs, and act up. That is why any episode of severe abdominal pain in a child requires examination by a doctor, and not independent treatment.
- Pain in the upper abdomen and around the navel
- Referring pain to the back
- Nausea and vomiting
- Refusal to eat, lethargy
- Bloating and loose stools
- Increased pain after fatty foods
Why ultrasound is not a diagnosis
Formulations such as reactive changes or enlargement of the pancreas are found in children’s reports very often, including in healthy children. The size of the gland in children is variable, and its echogenicity depends on the device, preparation and even the amount of gas in the intestines. Therefore, the diagnosis is made based on the totality of complaints, examination, amylase and especially lipase levels in the blood. An increase in enzymes several times higher than the upper limit of normal is considered significant. There is no need to treat an ultrasound finding in a healthy child without complaints.
- The size of the gland in children varies greatly
- Echogenicity depends on study conditions
- Diagnosis is made based on complaints and tests
- Lipase is more informative than amylase
- An isolated finding on ultrasound does not require treatment
Survey
The doctor examines the child, assesses abdominal tenderness, signs of dehydration, and rules out conditions requiring surgery, primarily appendicitis. Blood amylase and lipase, general blood test, liver tests, bilirubin, glucose and coprogram are prescribed. An abdominal ultrasound helps evaluate the gland, gallbladder, and ducts. In severe cases, an unclear picture or repeated episodes, a more in-depth examination is carried out to exclude ductal anomalies and hereditary causes.
- Examination by a pediatrician and exclusion of appendicitis
- Blood amylase and lipase
- General blood test
- Liver tests and bilirubin
- Abdominal ultrasound
- Coprogram
Treatment and nutrition
The basis is eliminating the cause and gentle treatment. In the first hours, if there is severe pain and vomiting, the doctor may recommend abstaining from food and giving water in small portions, and in case of severe dehydration, prescribe intravenous fluids. An early return to nutrition upon improvement is considered correct: children do not need long-term fasting. Meals begin with pureed porridges in water, vegetable soups, boiled meat and poultry, limit fatty, fried, smoked foods, carbonated drinks and fast food for two to four weeks. Pain relief and enzyme preparations are prescribed by the doctor.
- Treating the underlying cause
- Drink in small portions, if necessary, a dropper
- Early return to gentle nutrition
- Puree porridges, soups, boiled meat
- Eliminate fatty, fried, soda and fast food
- Medicines only as prescribed by a doctor