Recurrent Acute Pancreatitis in an Adolescent: A Case Report

Abstract

Acute pancreatitis is rare in children and adolescents, but its incidence is rising. Biliary lithiasis is an increasingly recognised cause of acute pancreatitis in the paediatric population. Delaying definitive surgical management after an episode of acute biliary pancreatitis significantly increases the risk of recurrence, which can complicate the clinical course and increase morbidity.

We report the case of an adolescent who presented with moderately severe acute biliary pancreatitis secondary to gallbladder calculi. He was managed
conservatively and discharged with advice to undergo elective laparoscopic cholecystectomy in 10-12 weeks. Before the planned surgery, he developed a recurrence of acute pancreatitis, necessitating a second admission and further conservative management. Characteristic abdominal pain, a serum amylase level at a diagnostic threshold, and diagnostic radiological imaging confirmed the diagnosis on both occasions. No congenital ductal anomaly was identified. He has been discharged with a plan for an interval laparoscopic cholecystectomy in 8-10 weeks.

Acute pancreatitis must always be considered in the differential diagnosis of abdominal pain in children and adolescents. In acute biliary pancreatitis, early identification of the biliary cause and timely relief of obstruction, followed by cholecystectomy, are essential to prevent morbidity.