Symptoms of Chronic Pancreatitis

Symptoms of chronic pancreatitis in children are variable and depends on the duration of the disease, the form and stage of the disease, the degree of disorder of the external and intrasecretory functions of the gland, the presence of concomitant pathology of other organs. Despite the variety of clinical symptoms of pancreatitis, the leading syndrome is considered painful.

Characterized paroxysmal pain in the upper half of the abdomen, epigastric region (77%), right and left hypochondrium (58%). In 10% of children, aching pain, worse after eating and in the second half of the day, is more often due to a violation of diet (coarse, fatty, fried, sweet, cold food, carbonated drinks), significant physical exertion and viral diseases. Pain crises last from 1 to 2-3 hours, less often 4-5 hours or up to several days. Note the irradiation of pain in the back, the left and right half of the chest, sometimes the sensations acquire a girdling character (56%). The attack, as a rule, weakens in the sitting position with the torso tilted forward in the knee-elbow position.

Another group of symptoms of chronic pancreatitis is dyspeptic disorders. The most typical decrease in appetite (78%), vomiting that occurs at the height of pain, nausea, eructation, heartburn, flatulence. Often there are constipation (38%) or dilution of stool (24%). During the manifestation of the disease in 30% of patients noted a decrease in body weight from 5 to 10 kg.

Usually, the disease is accompanied by asthenovegetative syndrome: patients complain of fatigue, headache, emotional lability, irritability. In some patients, severe pain syndrome is accompanied by an increase in body temperature, inflammatory changes in the blood.

In the period of exacerbation of pancreatitis, distinct morbidity is determined in the projection of the head, body or tail of the pancreas. Children are characterized by diffuse soreness simultaneously in several zones: epigastric, right and left hypochondrium, in the projection of the duodenum. Record the pathological symptoms of Cach, Mayo-Robson, show a bubble, a moderate increase in liver size.

Typically, the features of clinical symptoms are due to the severity of chronic pancreatitis. For severe form, long, severe pain crises with localization throughout the upper abdomen with irradiation and various dyspeptic disorders are characteristic. The frequency and severity of exacerbations increase with the age of the child. This is typical for pancreatitis, which developed against the background of pronounced organic changes in the duodenum (duodenostasis, diverticula, stenosing papillitis, arteriomesentral compression, etc.) and in the biliary tract (cholelithiasis, ductal system anomalies). Possible development of complications (false cysts, left-sided pleurisy, pancreatitis, gastroduodenal erosions and ulcers, abscesses, symptoms of cholestasis, diabetes mellitus, etc.).

With an average form, the clinical picture of pancreatitis is less pronounced, the course is relatively favorable. Pain syndrome occurs periodically after violations of diet, physical overwork. Pains are usually localized in epigastrium, left hypochondrium, sometimes intensified to severe pain attacks, but quickly stop. Dyspeptic disorders are moderately pronounced.

With a mild form of pain, usually short-term, are aching or paroxysmal. Local soreness is localized mainly in the projection of the pancreas, without irradiation. The prognosis of this form of pancreatitis is favorable.

[1], [2], [3], [4], [5]