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Journal of Pediatric Health Care and Medicine

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A Rare Case of Acute Pancreatitis in a Pediatric Patient with COVID-19

Author(s): Riti Bhalla

Introduction: Acute pancreatitis a common pediatric condition. While pancreatitis in adults is often due to gallstone disease and alcohol use, pancreatitis in children and adolescents usually arises from infection, medications, trauma, genetic variants, or anatomic abnormalities. Infectious causes of acute pancreatitis are largely viral, including mumps, measles, coxsackie, influenza, and Epstein Barr Virus. Herein, we present a case of acute pancreatitis in the setting of COVID-19 infection – a new clinical manifestation of the novel coronavirus. Case: A 5-year-old male with a history of horseshoe kidney and autism spectrum disorder presented with abdominal pain and vomiting for 2 days. Laboratory evaluation was consistent with acute pancreatitis; other infectious and anatomic etiologies of pancreatitis were ruled out, as was multisystem inflammatory syndrome in children (MIS-C). CT revealed an edematous pancreas with peripancreatic fluid, consistent with acute pancreatitis (Figure 1). Discussion: It is important to establish the etiology of acute pancreatitis in children, when possible, in order to prevent recurrence and progression to chronic pancreatitis, though up to 30 percent of cases are idiopathic after ruling out identifiable causes. In our patient, infectious and anatomic etiologies of pancreatitis were ruled out, as was MIS-C. As such, the diagnosis was attributed to COVID-19. Typically, COVID-19 causes a mild infection in children, sometimes with GI symptoms of abdominal pain and diarrhea. Given our patient’s case, it is important for clinicians to evaluate for pancreatic inflammation in COVID-positive patients presenting with non-specific abdominal symptoms. Likewise, practitioners should consider COVID-19 infection when aiming to establish an etiology of acute pancreatitis. Conclusion: As the pandemic continues and our knowledge of COVID-19 evolves, this case of acute pancreatitis represents a new clinical manifestation of the novel coronavirus. It is important that clinicians recognize this association in order to optimize patient management and prevent delay of appropriate intervention


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