1/10,000 children/yr, idiopathic/other (24%), trauma (17%),
systemic illness (15%), structural abnor. (14%), drugs (10%),
infections (8%)
Abd. pain &/or irritability (m/c), epi. T, N, V (subtle; infant, toddlers)
Dx criteria (≥2): (1) abd. pain compatible with AP, (2) s-amylase
&/or lipase ≥3 times, (3) imaging findings consistent with AP
US: biliary or anatomic abnor. of P
CT: Cx. of severe P
Fluid resuscitation [1st 24 hr, N/S with 5DW , >1.5-2x maintenance,
d/t hypovolemia, P microcirculation], meperidine, EN as early as
possible → monitor [BUN, Cr & urine output, 1st 48 hr → pain
mx.[AAP or NSAIDs → morphine] → early nutrition [within 48–72
hr of presentation, oral/EN, PN]


