title: The leaking pancreatic duct in childhood chronic pancreatitis.
abstract: The leaking pancreatic duct in childhood chronic pancreatitis presents with ascites and pleural effusion and is a potentially lethal condition. Seven children with this condition were seen in the period 2003-2006. The correct diagnosis was not entertained till a raised serum amylase was discovered. The diagnosis was confirmed by very high levels of amylase in the aspirated abdominal or pleural fluid. Computerized tomogram was the most useful imaging study and demonstrated a dilated pancreatic duct. All children were operated within 6 days of diagnosis by a Puestow's procedure in six and peripancreatic drainage in one. Six children made a prompt and lasting recovery after a Puestow's procedure while one child, also suffering from metastatic neuroblastoma, died in the immediate post operative period after peripancreatic drainage. We recommend prompt and definitive surgical management of this potentially lethal condition.
authors.affiliation: Department of Paediatric Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu 632004, India.
authors.forename: Dhruva Nath
authors.initials: DN
authors.lastname: Ghosh
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sen
authors.forename: Jacob
authors.initials: J
authors.lastname: Chacko
authors.forename: Gordon
authors.initials: G
authors.lastname: Thomas
authors.forename: Sampath
authors.initials: S
authors.lastname: Karl
authors.forename: John
authors.initials: J
authors.lastname: Mathai
mesh_terms: D000681:Amylases / Q000032:analysis*; D001201:Ascites / Q000209:etiology; D001202:Ascitic Fluid / Q000737:chemistry; D002648:Child; D006801:Humans; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging*; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000000981:diagnostic imaging; D010996:Pleural Effusion / Q000737:chemistry / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D000681:Amylases