Solid pseudopapillary tumor of the pancreas as a cause of recurrent pancreatitis.

Solid pseudopapillary tumor (SPT) of the pancreas is a rare pancreatic tumor mostly seen in young women. We here report a twelve-year-old girl presenting with recurrent attacks of pancreatitis. No history of a systemic disease, trauma, drug usage or infection was present. All other etiologic factors like familial, hypertriglyceridemia, hypercalcemia, cystic fibrosis, medications were excluded. On abdominal ultrasound a heterogeneous mass was noticed at the tail of pancreas. Computerized tomography and magnetic resonance imaging proved that the mass was cystic. The mass was surgically removed. The diagnosis was pancreatic solid cystic papillary epithelial neoplasm. Although acute pancreatitis due to SPT was exceptionally reported, this is the first description of SPT leading to recurrent pancreatitis especially in children.

Lymphocytic colitis in a child with non-responsive celiac disease.

In celiac disease, symptoms usually improve with strict adherence to diet. Some patients however do not show improvement despite of diet therapy. We here report a girl with non-responsive celiac disease whose diarrhea did not improve despite of a gluten free diet. A 12-year-old girl with recurrent diarrhea and failure to thrive was diagnosed with celiac disease. After six months of gluten-free diet her symptoms persisted. Adherence to diet was considered as correct and complete by a dietitian evaluation and by anti-endomysial antibodies that had become negative. Treatment with pancreatic enzymes, metronidazole or lactose free diet did not improve her symptoms. Colonoscopy was performed and lymphocytic colitis was diagnosed on histology from colonic biopsies. After mesalamine therapy diarrhea ceased, and weight and height z scores increased. Lymphocytic colitis, which is uncommonly seen in children compared to adults, should be considered in nonresponsive celiac disease in children.