Chronic pancreatitis beginning in childhood and adolescence
J. M. Little, N. Tait, A. Richardson and R. Dubois
Department of Surgery, Westmead Hospital, Westmead, NSW, Australia.
We identified 10 patients with symptoms beginning before the age of 20
years in a group of 69 patients with proven chronic pancreatitis. Six of
the 10 patients were women. There was a family history of pancreatitis in
three patients and alcohol exposure in seven patients. Three patients were
dependent on narcotics at the time of presentation. Six of the 10 patients
had pancreatic duct dilatation to 10 mm or more in diameter during
observation. These six patients underwent pancreaticojejunostomy, with
clinical improvement in five patients. The median time of follow-up was 19
years from presentation. No patient developed diabetes and one developed
malabsorption. Only three patients were free of pain, but four other
patients had only mild episodes that rarely required hospital admission.
One patient died of metastatic abdominal carcinoma of unknown origin 51
years after developing familial pancreatitis. Chronic pancreatitis
beginning at a young age is sufficiently common to merit special awareness.
It is compatible with prolonged survival, and pancreaticojejunostomy may
help if the pancreatic duct reaches sufficient size. The disease does not
seem to burn out with time.
