Pediatric Pancreas Disorders
These are most commonly the congenital anomalies that occur as a result of aberrant development during child growth. These include pancreas divisum (most common anatomic variant of the pancreas), annular pancreas, agenesis of the dorsal pancreatic anlagen and ectopic pancreatic tissue.
Syndromes that can manifest with pancreatic pathology include Beckwith Wiedemann syndrome, von Hippel-Lindau disease and autosomal dominant polycystic kidney disease. These usually present with multiple congenital pancreatic cysts.
Children with cystic fibrosis and Shwachman-Diamond syndrome frequently present with chronic pancreatitis leading to pancreatic insufficiency.
Primary pancreatic neoplasms are rare in children and are divided into exocrine tumors such as pancreatoblastoma and adenocarcinoma and into endocrine or islet cell tumors. Islet cell tumors are classified as functioning (Insulinoma, gastrinoma, VIPoma and glucagonoma) and nonfunctioning tumors. Solid-cystic papillary tumor is probably the most common pancreatic tumor in Asian children.
Most common cause of acute pancreatitis in children is trauma. This can be both accidental or non-accidental. Pancreatic injury in children is mostly seen in isolation and not in association with multiple organ injury. Other causes of pancreatitis in the pediatric population include infection (mumps), multisystem disease (vasculitis, lupus, sepsis, shock), hemolytic uremic syndrome, steroids, acetaminophen, metabolic-toxic causes (hyperlipidemia, hypercalcemia), and gallstone pancreatitis (secondary to sickle cell disease)
