TRAUMATIC AND NONTRAUMATIC PANCREATITIS IN PEDIATRIC-SURGERY

Today pancreatitis is classified only as acute or chronic. In pediatri c surgery it seems more practical to distinguish traumatic from non-tr aumatic cases. To show whether there is also a difference in the manag ement of these two groups we analysed all patients treated between 197 7 and 1991 for pancreatitis. It was most impressive that traumatic cas es were operated on in 86% and the rate of pseudocysts reached 61.5% w hereas non-traumatic pancreatitis required surgical intervention in 50 % and developed pseudocysts in 17%. Following trauma elevation of seru m enzyme concentration lasted longer in a significant number of patien ts but became normal without any hint of further complications. In non -traumatic pancreatitis it is recommended that surgery should be avoid ed and reserved for com plications. Exceptions are obstructions of the pancreaticobiliary ducts which need early removal to prevent chronici ty of the disease and functional loss of the organ.