{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T05:48:18Z","timestamp":1768888098000,"version":"3.49.0"},"reference-count":8,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,22]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Necrotising pancreatitis is a rare but serious complication of acute pancreatitis in children. We report a case of a toddler who presented with a 1\u2009day history of persistent non-bilious vomiting, intermittent pallor and irritability, without fever or diarrhoea. Initial examination was non-specific, but progressive abdominal tenderness and new onset of fever prompted imaging and laboratory investigations. Elevated inflammatory markers and serum lipase, along with contrast-enhanced CT findings, confirmed a diagnosis of necrotising pancreatitis. The patient was transferred to a tertiary hospital, recovering after 9\u2009days of supportive care. Follow-up imaging showed resolution of peripancreatic fluid, and no long-term complications were identified. This unexpected presentation of idiopathic necrotising pancreatitis in a young child emphasises the need for early consideration of acute pancreatitis in paediatric patients with non-specific abdominal symptoms, to avoid delays in diagnosis and treatment.<\/jats:p>","DOI":"10.1136\/bcr-2025-269534","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:20:19Z","timestamp":1768839619000},"page":"e269534","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Paediatric necrotising pancreatitis"],"prefix":"10.1136","volume":"19","author":[{"given":"Nelithma","family":"DeSilva","sequence":"first","affiliation":[{"name":"Curtin Medical School, Perth, Western Australia, Bentley, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baci","family":"Alder","sequence":"additional","affiliation":[{"name":"Medical Faculty, Curtin Medical School Medical school in Bentley, Western Australia, Bentley, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Saha","sequence":"additional","affiliation":[{"name":"Medical Faculty, Curtin Medical School Medical school in Bentley, Western Australia, Bentley, Western Australia, Australia"},{"name":"St John of God Midland Public and Private Hospitals, Midland, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0760-3544","authenticated-orcid":false,"given":"Chia","family":"Saw","sequence":"additional","affiliation":[{"name":"Paediatric, SJOG Midland Public Hospital, Midland, Western Australia, Australia"},{"name":"Curtin University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"2026011908200969000_19.1.e269534.1","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1111\/jpc.14688","article-title":"Paediatric pancreatic diseases","volume":"56","author":"Coffey","year":"2020","journal-title":"J Paediatr Child Health"},{"key":"2026011908200969000_19.1.e269534.2","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.jpeds.2012.09.037","article-title":"Acute necrotizing pancreatitis in children","volume":"162","author":"Raizner","year":"2013","journal-title":"J Pediatr"},{"key":"2026011908200969000_19.1.e269534.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjpo-2022-001487","article-title":"Acute pancreatitis in children - morbidity and outcomes at 1 year","volume":"6","author":"Bhanot","year":"2022","journal-title":"BMJ Paediatr Open"},{"key":"2026011908200969000_19.1.e269534.4","doi-asserted-by":"crossref","first-page":"5639","DOI":"10.1097\/MS9.0000000000002456","article-title":"Necrotizing pancreatitis in an 8-year-old girl: a case report from Nepal","volume":"86","author":"Jha","year":"2024","journal-title":"Ann Med Surg (Lond)"},{"key":"2026011908200969000_19.1.e269534.5","first-page":"2321","article-title":"Acute abdominal pain in children","volume":"67","author":"Leung","year":"2003","journal-title":"Am Fam Physician"},{"key":"2026011908200969000_19.1.e269534.6","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.paed.2017.07.009","article-title":"Paediatric pancreatitis","volume":"27","author":"Yeo","year":"2017","journal-title":"Paediatr Child Health"},{"key":"2026011908200969000_19.1.e269534.7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.31584\/jhsmr.2021812","article-title":"Imaging of Pancreatitis in Children","volume":"40","author":"Chittchang","year":"2021","journal-title":"J Health Sci Med Res"},{"key":"2026011908200969000_19.1.e269534.8","doi-asserted-by":"crossref","first-page":"265","DOI":"10.2214\/AJR.21.25508","article-title":"Current State of Imaging of Pediatric Pancreatitis: AJR Expert Panel Narrative Review","volume":"217","author":"Trout","year":"2021","journal-title":"AJR Am J Roentgenol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T16:20:21Z","timestamp":1768839621000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,19]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-269534"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269534","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}