Pediatric emergency medicine trisk 2067 2067

in adults, including the Modified Glasgow score, Ranson criteria, and APACHE II, however they have been shown to be poor predictors of outcome in children Recent studies in children have attempted to better classify the disease in children Clinical Considerations Clinical Recognition The majority of children with acute pancreatitis initially present with nonspecific signs and symptoms Abdominal pain (87%) and vomiting (64%) are the most common presenting symptoms The character of the abdominal pain may range from tolerable discomfort to severe pain Classically, the pain is constant and localized to the epigastrium and may radiate to the back (left or right scapula) or to the right or left upper quadrants The pain is classically described as knifelike in quality and is aggravated when the patient lies supine Vomiting may be severe and protracted Fever, abdominal distention, and jaundice may also be present In cases of severe necrotic pancreatitis, patients may complain of dizziness or present with hypotension and shock Mental status changes including psychosis and coma are common in necrotic pancreatitis