Acute and chronic treatment of pancreatitis in children

Abstract

Introduction: In the structure of chronic diseases in children one of the first place takes the pathology of the digestive organs, one of which consist the pancreas gland disease incidence is increasing in all age groups. Treatment consists of a suppression effect of the pancreatic enzymes by administering antienzymes, preventing infection (with antibiotics and reduce inflammation). It is administered selective spasmolytic: Diuspatalin, Buscopan or Spasmomen, administered at least 2-3 weeks in pancreatitis. Antibiotics are administered in cases of toxic syndrome with fever, signs o f inflammation in blood test and in pancreas damage in association with respiratory diseases (acute bronchitis, pneumonia). Proton pump inhibitors: Omeprazole, Lansoprazole. Antacids, Maalox (dose depending on the age) x 3 times a day. Infusion therapy - S.5 % -10 % glucose, 0.9 % s.NaCl, s. Ringer. Fluids intravenous (i.v) is given for purposes of detoxification and hydro-electrolytic rebalancing. Purpose and objectives: Targeted full analysis of efficacy of the treatment administered to children with acute pancreatitis (AP) and chronic pancreatitis (CP) in the acute phase. Materials and methods: 150 children were included with AP and CP, they were hospitalized in the pediatric gastroenterology department SCMC PMSI "V. Ignatenco" in 2010-2013. Group 1 includes 75 children with AP (basic group) and second group - 75 children with CP in acute phase (control group). The confirmation of positive diagnosis was based on criteria: Gastrointestinal anamnesis, physical examination, laboratory investigations, explorations instrumental: EGDS, transabdominal ultrasound of the digestive organs. Results and discussion: From concurrent diagnoses was presented in patients with AP - ketoacidosis non-diabetic children- 48 ( 64 % ), dehydration of 23 children who constituted 30.6 % of cases, which confirms receiving treatment in children with AP perfuzional percentage greater compared to patients with CP in acute phase . Pathological signs in children with AP were more frequently Cacea, Meyo - Robson, AP in children - Mendel, Cacea, pain in the Saffar zone, Meyo - Robson. Malformation of the gallbladder was found to children with AP in 32 children (42.6%), but children with CP in acute phase of 28 children 37.3%. Concurrent diagnosis of chronic gastroduodenitis in acute phase was founded to children with CP in the acute phase-49 children (65.3%), but children with AP - 28 children (30.6%). It was found that patients with AP receiving infusion therapy (s. 5% glucose, 0.9% NaCl, Ringer ) to 48 (64%) children, but children with CP in the acute phase to 29 children (38.6%) , antibiotic therapy has been indicated in 2/3 of the cases . PPI were administered to all children with AP and CP. The enzyme therapy was administered to all patients with AP and CP under the clinical and laboratory data of exocrine insufficiency syndrome. The administration of the indicated treatment contributed to healing children. Conclusion: Basic preparations in the treatment of AP and CP are PPI, the enzyme therapy, diet therapy, infusion therapy. Accompanying diseases most common in children with AP and CP are congenital malformations of gallbladder, GERD, DGR, chronic gastroduodenitis in acute phase, ketoacidosis non-diabetic.