Exocrine Pancreatic Insufficiency: A Case Report at the Mother and Child Center of the Chantal Biya Foundation

Abstract

Introduction: Exocrine pancreatic pathologies are rare conditions in children. Their diagnosis should be evoked and systematically sought in any child presenting with severe acute or chronic abdominal pain, malnutrition and steatorrhea. The management is complex and may be multidisciplinary over the long term. Case Presentation: We report the case of a 7-month-old infant referred for unexplained malnutrition. Born macrosomic, since the age of 6 weeks he had been vomiting and not gaining weight. Then the progressive appearance of steatorrhea and a malabsorption syndrome led to acute malnutrition. Exocrine pancreatic insufficiency was demonstrated with low lipase and the patient was taken care of. Treatment consisted of oral administration of pancreatic enzymes and nutritional rehabilitation. Significant and favorable evolution was noted as early as within two weeks from treatment initiation. Conclusion: Exocrine Pancreatic Insufficiency (EPI) is a rare but severe condition in pediatrics. The etiological diagnosis is often linked with genetic diseases, and so not always obvious in our context. However, clinical evaluation and complementary examinations may serve as diagnostic guidelines. Management is palliative and allows rapid improvement of the patient as early as within two weeks from start.