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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.