Acute pancreatitis in the paediatric age group: a personal experience

practitioner with a paediatric practice and the paediatrician encounter a large number of diffi- culties in this field of pathology. Therefore, an adequate and correct "management" of chil- dren with acute or chronic pancreatitis seems to be mandatory. Abstract. - Although relatively rare, acute pancreatitis is the most common disease com- plex involving the pancreas in the paediatric age group. The etiology of the disease is often unknown, and Italian epidemiological data on the paediatric population and, in particular, on the etiology of the disease are not available (except for studies of prevalence). Within the field of the most frequently encountered pan- creatitis in the age range of our interest (i.e. 0- 18 years), not only the commonly observed forms whose etiopathogenesis is ascribable to cholelithiasis must be mentioned but also those forms due to proteic-caloric malnutrition that are becoming increasingly common. The presenting clinical symptoms and signs may not be typical and the laboratory tests may not always be sensitive enough. In such age range chronic recurrent pancreati- tis plays a very important epidemiologic role. Approximately 40% of children and teenagers ad- mitted to the hospital with a diagnosis of pancre- atitis report a previous episode of the disease. Irreversible changes in pancreatic parenchyma develop in those patients in whom the disease progresses, leading to pancreatic insufficiency. Such a morbid condition (chronic pancreatitis) is more often observed in adolescents, in whom the disease manifests itself with a vague repetitive dyspeptic symptomatology, after alternating re- missions and recrudescences, not always clini- cally evident. In children, the clinical picture most commonly encountered is represented by recur- rent abdominal pains, in view of the fact that the patients are frequently affected by thalassaemia. The pseudocystic evolution of the disease is the most common organic damage resulting from the chronic progression of the pancreatic impairment. A few differences have been found with re- spect to severity, etiology, and mortality of pan- creatitis in the paediatric age group as com- pared with older age groups. Both the general