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... pancreatitis is due to an organ injury with a subsequent inflammatory response that may involve both adjacent and distant structures. The first pathogenetic event may be represented by an acinar cell injury (Figure 1) that produces pancreatic edema with the activation of the inflammatory pathway. The release of cytokines and chemokines leads to a systemic inflammatory response (SIRS) and to complications such as pancreatic necrosis, shock and distant organ failure. ...
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... per 100 000 children per year. It is therefore an important differential for children with an acute abdominal presentation, however the cases are few [1]. Paediatric cases are estimated to be <1% of all cases of acute necrotizing pancreatitis [2]. ...
The diagnosis of acute necrotising pancreatitis is a rare event in the Paediatric Emergency Department (ED). We report a case of acute pancreatitis in a paediatric patient, diagnosed in our ED, a tertiary level paediatric hospital. This child presented with vague symptoms of constipation, abdominal pain and back pain, and on clinical examination had a distended abdomen with peritonism. She rapidly deteriorated and needed aggressive fluid resuscitation in the ED for treatment of septic shock. The diagnosis of acute pancreatitis (AP) was only considered once elevated amylase levels were apparent. Whilst AP is an important differential diagnosis in a patient who is presenting with acute abdominal symptoms, the diagnosis in children in particular is seldom and thus easily overlooked in the previously healthy child.
