Enlarged Kidneys and Pancreas in Pediatric Patients

The kidneys are larger than the pancreas?

Hello doctor, my son is currently over four years old.
He had cold symptoms before January 20.
On the night of January 27, he kept vomiting, so we took him to see a doctor.
The doctor gave him an antiemetic, and afterward, he did not drink any water.
Around 2 AM, he developed a fever and took medication.
He had a fever all day on Sunday, but by Monday, the fever was gone.
However, he complained of abdominal pain and pain near his lower back, as well as pain in the spine area.
On February 3, he mentioned that he still felt pain, so we took him to the hospital for an ultrasound, X-ray, and urinalysis.
After the ultrasound, we proceeded with the urinalysis.
The doctor said there was fluid in the kidneys and that the kidneys were enlarged (right kidney measuring 82mm, left kidney measuring 74mm), and the pancreas was also enlarged (81×36mm).
The doctor advised us to continue monitoring.

Could you please tell me if this condition will affect his health? Is the enlargement of the kidneys and pancreas related to the cold, vomiting, or the fact that he did not drink water after 8 PM on Saturday until the next day? (He indicated he was thirsty when he woke up in the middle of the night and only drank a little water with his medication).
He still complains of abdominal pain (but generally has good energy; he only mentions the pain when asked).
Is it normal for a gastrointestinal virus to cause pain for this long? Thank you.

Niming, 30~39 year old female. Ask Date: 2018/02/05

Dr. Xiao Kaiwen reply Pediatrics

There are many causes of abdominal pain in children, and it is not always due to a gastroenteritis.
Even in cases of gastroenteritis, the severity of symptoms can vary greatly from mild or asymptomatic to severe dehydration.
An enlarged kidney or pancreas is merely a finding from an examination; the underlying cause and its potential impact on the body are not always clear.
It is essential to closely discuss and collaborate with your physician for appropriate follow-up.

Reply Date: 2018/02/05

More Info

Enlarged kidneys and pancreas in pediatric patients can be concerning, especially when accompanied by symptoms such as abdominal pain, vomiting, and fever. In your son's case, the ultrasound findings indicate that both the kidneys and pancreas are enlarged, which warrants careful consideration and follow-up.

Firstly, let's address the potential causes of the enlargement of these organs. In children, kidney enlargement (hydronephrosis) can occur due to various reasons, including urinary tract obstruction, infections, or congenital anomalies. The pancreas can also become enlarged due to inflammation (pancreatitis), infections, or other underlying conditions. Given that your son had symptoms of a gastrointestinal illness, it is possible that the vomiting and dehydration contributed to the kidney enlargement. Dehydration can lead to a reduction in urine output, which may cause the kidneys to swell as they retain fluid.

The fact that your son experienced abdominal pain and back pain could be related to the enlarged kidneys or pancreas. In some cases, the pain may stem from the pressure exerted by the swollen organs on surrounding structures. Additionally, gastrointestinal issues, such as a viral gastroenteritis, can cause abdominal pain that may persist even after other symptoms have resolved.

Regarding the relationship between the recent illness and the organ enlargement, it is plausible that the dehydration from vomiting and not drinking enough fluids could have exacerbated the situation. When the body is dehydrated, the kidneys may struggle to function optimally, leading to swelling. However, it is also essential to consider other underlying conditions that may not be immediately apparent.

As for the ongoing abdominal pain your son is experiencing, it is not uncommon for children to have lingering discomfort after a gastrointestinal illness. However, if the pain persists or worsens, it is crucial to follow up with your pediatrician. They may recommend further imaging studies or laboratory tests to rule out any complications or other underlying issues.

In terms of management, it is vital to ensure that your son stays well-hydrated, especially after episodes of vomiting. Encourage him to drink fluids regularly and monitor for any signs of dehydration, such as decreased urine output, dry mouth, or lethargy. If he continues to experience pain or if new symptoms arise, such as fever, changes in appetite, or changes in bowel habits, it is essential to seek medical attention promptly.

In conclusion, while the enlargement of the kidneys and pancreas in your son is concerning, it is essential to consider the context of his recent illness and symptoms. Continued monitoring and follow-up with your healthcare provider are crucial to ensure that any potential complications are addressed and that your son receives appropriate care. If you have any further concerns or questions, do not hesitate to reach out to your pediatrician for guidance. They can provide personalized recommendations based on your son's specific situation and health history.

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