Mike Preis, MD
- Consider pancreatitis in the pediatric patient with abdominal pain and vomiting especially after trauma, a viral illness, or a patient who is taking valproic acid (#1 medication cause of pediatric pancreatitis).
- Workup the pancreatitis patient with a CBC, complete metabolic panel, and lipase level looking for a 3 fold increase in lipase. You may see leukocytosis, hemoconcentration, hyperglycemia, hypocalcemia, acidosis, hypomagnesemia, and elevated AST/ALT. The initial imaging modality of choice is an abdominal ultrasound.
- Management is making the patient NPO, start IVF, and pain control. Morphine is still acceptable in the pediatric patient (limited data on whether it causes Sphincter of Odi spasms). Early re-feeding is still being studied, so start feeding when pain is managed.