Treatment of pancreatitis in children

We all know the pancreas, which is a very inconspicuous small organ deep in the upper abdomen of our body - the pancreas. Although the pancreas is small, it plays an extraordinary role and is one of the most important organs in the human body. Because it is a gland with exocrine function, its physiological effects and pathological changes are closely related to life. The most common disease of the pancreas is pancreatitis. Pancreatitis is a disease of the pancreas caused by the autodigestive action of trypsin. Pancreatitis in children should be treated early. So how should pancreatitis in children be treated? Let’s take a look at it together below.

(1) Fasting and nasogastric tube decompression to maintain gastrointestinal decompression and prevent vomiting and aspiration. Giving whole-body motility drugs can reduce abdominal distension.

(2) Replenish body fluids and prevent and treat shock. All patients should be given intravenous fluids, electrolytes, and calories to maintain circulatory stability and water-electrolyte balance. Prevent hypotension and improve microcirculation.

(3) For patients with a clear diagnosis of antispasmodic and analgesic conditions, symptomatic analgesics can be given in the early stages of the disease. However, it is advisable to give antispasmodics at the same time. Morphine is contraindicated to avoid spasm of the sphincter of Oddis.

(4) Inhibition of pancreatic exocrine secretion and pancreatic enzyme gastric tube decompression, H2 receptor blockers, anticholinesterase drugs, somatostatin, etc. are generally used for patients with more serious conditions. Trypsin inhibitors such as aprotinin and gabexate have a certain inhibitory effect on trypsin.

(5) Nutritional support: Early fasting, mainly relying on total parenteral nutrition (TPN). When the abdominal pain, tenderness and intestinal obstruction symptoms are relieved, you can resume eating. Except for patients with hyperlipidemia, fat emulsion can be used as a heat source.

(6) Antibiotics should be given in the early stage of treatment. In severe pancreatitis complicated by pancreatic or peripancreatic necrosis, intravenous administration of broad-spectrum antibiotics or selective intestinal administration of antibiotics can prevent bacterial infection caused by intestinal flora translocation.

2. Surgery

Pancreatic abscess, pancreatic pseudocyst, and pancreatic necrosis with infection are serious life-threatening complications of acute pancreatitis. If the diagnosis is uncertain; there is secondary pancreatic infection; there is concurrent biliary disease; or the clinical symptoms continue to worsen despite reasonable supportive treatment, surgical treatment should be performed.

There are two main surgical methods: ① Laparotomy to remove necrotic tissue, place multiple multi-porous drainage tubes for continuous irrigation after surgery, and then suture the incision. ② Laparotomy to remove necrotic tissue and partially open the wound for drainage. During the operation, gastrostomy, jejunostomy (for enteral nutrition support) and biliary drainage can be performed simultaneously. Occasionally, single abscesses or infected pancreatic pseudocysts can be treated with percutaneous catheter drainage.

The above article introduces the treatment methods of pediatric pancreatitis in detail. I believe everyone understands it. Through the article, we know the importance of the pancreas to us, so when a child suffers from pancreatitis, he must be treated in time.