Abstract
The leaking pancreatic duct in childhood chronic pancreatitis presents with ascites and pleural effusion and is a potentially lethal condition. Seven children with this condition were seen in the period 2003–2006. The correct diagnosis was not entertained till a raised serum amylase was discovered. The diagnosis was confirmed by very high levels of amylase in the aspirated abdominal or pleural fluid. Computerized tomogram was the most useful imaging study and demonstrated a dilated pancreatic duct. All children were operated within 6 days of diagnosis by a Puestow’s procedure in six and peripancreatic drainage in one. Six children made a prompt and lasting recovery after a Puestow’s procedure while one child, also suffering from metastatic neuroblastoma, died in the immediate post operative period after peripancreatic drainage. We recommend prompt and definitive surgical management of this potentially lethal condition.
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Mathew P, Wyllie R, Caulfield M, Steffen R, Kay M (1994) Chronic pancreatitis in late childhood and adolescence. Clin Pediatr 33(2):88–94
Crombleholme TM, deLorimier AA, Way LW, Adzick NS, Longaker MT, Harrison MR (1990) The modified Puestow’s procedure for chronic relapsing pancreatitis in children. J Pediatr Surg 25:749–754
Nealon WH, Thompson JC (1993) Progressive loss of pancreatic function in chronic pancreatitis is delayed by main pancreatic duct decompression. Ann Surg 217:458–468
Van Camp JM, Polley TZ, Coran AG (1994) Pancreatitis in children:diagnosis and etiology in 57 patients. Pediatr Surg Int 9:492–497
Festen C, Severijnen R, Staak Fvd, Rieu P (1991) Chronic relapsing pancreatitis in childhood. J Pediatr Surg 26:182–183
Moir CR, Konzen KM, Perrault J (1992) Surgical therapy & long term follow up of childhood hereditary pancreatitis. J Pediatr Surg 27:282–287
Dubay D, Sandler A, Kimura K, Bishop W, Eimen M, Soper R (2000) The modified Puestow procedure for complicated hereditary pancreatitis in children. J Pediatr Surg 35:343–348
Little JM, Tait N, Richardson A, Dubois R (1992) Chronic pancreatitis beginning in childhood and adolescence. Arch Surg 127:90–92
Mucklow ES, Freeman NV (1990) Pancreatic ascites in childhood. Br J Clin Pract 44:248–51
Ranuh R, Ditchfield M, Clarnette T, Auldist A, Oliver MR (2005) Surgical management of a pancreaticopleural fistula in a child with chronic pancreatitis. J Pediatr Surg 40:1810–1812
Cameron JL, Kieffer RS, Anderson WJ, Zuidema GD (1976) Internal pancreatic fistulas: pancreatic ascites and pleural effusions. Ann Surg 184:588–593
Lipsett PA, Cameron JL (1992) Internal pancreatic fistula. Am J Surg 163:216–220
Siegel MJ, Martin KW, Worthington JL (1987) Normal and abnormal pancreas in children: US studies. Radiology 165:15–18
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Ghosh, D.N., Sen, S., Chacko, J. et al. The leaking pancreatic duct in childhood chronic pancreatitis. Pediatr Surg Int 23, 65–68 (2007). https://doi.org/10.1007/s00383-006-1793-6
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DOI: https://doi.org/10.1007/s00383-006-1793-6