Acute hemorrhagic pancreatitis is a well known clinical entity,1-3 but rare in the pediatric age group. The signs and symptoms are nonspecific and resemble those found in many common systemic and abdominal diseases.3 This illness is characterized by increased serum and urinary amylase and hyperglycemia; however, serum amylase is increased in only about 65% of cases,4 and either hyper- or hypoglycemia may occur.3,5 In adults, severe electrolyte disturbances and various associated electrocardiographic changes have been described.6-8
This is a report of a 10-year-old girl with acute hemorrhagic pancreatitis associated with severe persistent electrolyte disturbances and electrocardiographic changes. Since Edmonson and Berne9 emphasized the significance of hypocalcemia accompanying pancreatitis, the serum calcium level has been a point of special interest in adults.10 Among 75 cases of acute and chronic pancreatitis reported in the pediatric literature since 1944,1,2,5,11-26 in only 11 were calcium levels