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Paediatric Pancreatic Cysts – how they form and what to look out for

Pancreatic cysts are fairly uncommon at AHC, but when they do occur they are normally the result of an accident, such as when children fall heavily onto the handles of a bicycle.

In 2016, AHC treated 3 pancreatic cyst cases, “Children who came to AHC complained of pain due to abdominal trauma…which happened as a result of crashing their bike and hitting their stomach area”, says Dr Sar Vuthy, AHC’s Chief of Surgical Unit.

Besides localized abdominal pain, there are another symptoms of the development of a pancreatic cyst; such as abdominal distension, persistent vomiting, nausea, inability to eat, weight loss and fever. To clarify the source of the pain, AHC ordinarily will conduct an ultrasound.

“If we find a cyst inside the patient’s pancreas, we ask the family for permission to do surgery. But not every patient needs surgery – if a case is not so dangerous or not difficult, and the patient is not complaining of too much pain, patients can receive medication treatment and regular follow up”, says Dr Vuthy.

AHC’s doctors warn parents to be careful if their kids experience any kind of abdominal trauma – such as falling onto their bike handles – as this could result in the formation of a cyst in the pancreas. Patients with pancreatic cysts rarely die, but it does need to be treated.
 

Case Study – Thida’s unlucky bike ride:

Thida* is a healthy six year old girl from Pursat province. Her parents, who are small business owners, care for her a great deal and allow her a lot of freedom to play and explore outdoors. Thida loves riding her bicycle riding and rides around her village almost every day.

One day, she accidentally crashed her bike and the handlebars struck her hard in the abdomen. Thida felt a lot of pain, but at first hide this from her parents, so that she would not get into trouble.

Three days later, Thida could not stand the pain. She could not eat, was vomiting a lot and in distress with the pain. She finally came clean with her mother and told her what had happened to her.

Rather than being angry, Thida’s mother was concerned and worried about her daughter’s condition. She sent Thida to a nearby clinic in Pursat province. She was treated there with medicines for a few weeks, but still her health did not improve greatly. Her neighbors recommended that Thida be taken to Angkor Hospital for Children and Thida’s mother decided to bring her to Siem Reap.

AHC’s doctors suspected a cyst growing inside Thida’s stomach and proceeded with an ultrasound. The result from abdominal scanning showed that Thida had a cyst on her pancreas that required surgery to remove. Thida was operated on in December 2016 at AHC and within one week post-surgery, Thida’s outlook was much better; she could eat and drink freely without vomiting or nausea. Soon after, she was released from the hospital and returned with her family to Pursat province.

However, her problem unexpectedly returned in January 2017. Thida and her mother quickly came back to AHC. Doctors found that a second cyst was blocking Thida’s pancreas, and she required a second surgery. Doctors keep her in the hospital for observation after the second surgery to see if she improved, and then allowed her to return home.

Now, Thida is happy and healthy again, back in her village in Pursat. Of course, she has promised her parents to be a lot more careful when riding her bike!

*Patient’s name has been changed for confidentiality reasons.

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