[Primary interstitial pancreatitis or dyschylic pancreatitis in children. Apropos of 13 cases].

During a retrospective review of more than 1,000 pediatric pancreas specimens obtained by autopsy or biopsy, 13 cases of primitive interstitial pancreatitis (PIP) were identified. The morphologic diagnosis of PIP is based on the following histological features: presence of abundant, inspissated, PAS-negative intraductal secretions, overdistension and focal rupture of the intrapancreatic ducts, and presence of a focal, extensive inflammatory infiltrate. PIP should be distinguished from cystic fibrosis, necrotizing pancreatitis, and passive secondary interstitial infiltrates associated with extensive retroperitoneal cellulitis caused by septicemia or abdominal surgery. Clinical diagnosis is difficult and was not considered in the ten children under four years of age. In the three children over five, the presence of recurrent abdominal pain with mild ascitis and jaundice led to the correct diagnosis. Pathological findings suggest two possible pathophysiologic hypotheses: lesions may develop proximal to a mechanical malformative obstruction that is, however, only very rarely found, according to a more likely alternative, quantitative and qualitative modifications of pancreatic secretions may occur as a result of severe dehydration or use of drugs (corticosteroids, diuretics), justifying the term "dyschylic pancreatitis" coined by G. Seifert.