What Is Pancreatitis, Pediatric?
Source: Genetic and Rare Diseases (GARD) Information Center
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Pancreatitis in Children
Childhood Pancreatitis; Pediatric Pancreatitis
Pancreatitis is inflammation of the pancreas. Pancreatitis can be acute (occurring suddenly and usually self-resolving after a few days) or chronic (long-lasting). While both forms of pancreatitis are more common in adults, they can also develop in children. Explore symptoms and causes of pancreatitis in children.
Children with visible anatomy
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Pancreatitis
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Source: Genetic and Rare Diseases (GARD) Information Center
Mutation
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In the largest study of its kind, an international group of researchers found that genetics, birth defects, and ethnicity may play important roles in the occurrence of pancreatitis in children. Pancreatitis, or inflammation of the pancreas, is accompanied by abdominal pain, nausea, vomiting, and, in severe cases, permanent tissue damage. Pancreatitis can be acute (occurring suddenly and usually self-resolving after a few days) or chronic (long-lasting). In some cases, recurring acute episodes can lead to the more debilitating chronic form of the disease. While both forms of pancreatitis are more common in adults, they can also develop in children. However, researchers have struggled to identify the factors that put young people at risk for pancreatitis, partly because the most common risk factors for adults—gallstones and heavy alcohol use—are rare in children.
The multinational INSPPIRE (International Study Group of Pediatric Pancreatitis: In Search for a Cure) consortium was established to investigate the risk factors and outcomes of pediatric pancreatitis. The consortium, which has enrolled the largest cohort of pediatric pancreatitis patients to date, collected genetic, demographic, and clinical data from 301 children (girls and boys aged 19 and under) with acute recurrent or chronic forms of pancreatitis. The most common risk factor for pancreatitis in children was at least one mutation in any of four genes that are known to be associated with pancreatitis—CFTR, PRSS1, SPINK1, and CTRC. Mutations in PRSS1 and SPINK1 were more common in children with chronic pancreatitis than in children with acute recurrent pancreatitis, which means that mutations in these genes may increase the risk of transitioning from acute to chronic pancreatitis. Another risk factor found was obstruction of the pancreatic duct, most frequently by a relatively common birth defect known as pancreas divisum, in which the pancreas is drained by two smaller ducts instead of a single one. Other risk factors for pancreatitis that were identified were toxic or metabolic factors and autoimmune diseases, but they were not as common as genetic or obstructive factors. Many of the children in the study were found to have multiple risk factors for pancreatitis, suggesting that the disease may result from a complex interplay among more than one factor. The researchers also found that non-Hispanic children were more likely than Hispanic children to develop chronic pancreatitis. In addition to identifying risk factors, the INSPPIRE researchers also examined the burden of disease in children with pancreatitis. They found that children with both forms of pancreatitis endured significant abdominal pain, along with a number of emergency room visits and hospitalizations. Children with chronic pancreatitis had a higher number of emergency room visits and hospitalization than children with recurrent acute episodes, underscoring the need to diagnose and treat pancreatitis early to avoid progression of the disease to the chronic form.
Additional research is needed to tease out how these factors drive pancreatitis development and progression in children. However, overall, the results in this study suggest that there are potential ways to screen for increased risk of pancreatitis in children, such as genetic testing, possibly providing the opportunity for early intervention before the disease develops or becomes chronic.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Stomach pain
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Source: Genetic and Rare Diseases (GARD) Information Center
Calcified pancreatic duct stones with some free intra-abdominal fluid
Image by James Heilman, MD
To diagnose pancreatitis and find its causes, doctors use
A health care professional will ask
During a physical exam, the health care professional will
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIH)
Ultrasound, Endoscopic (EUS), With Biopsy
Image by © 2022 Terese Winslow LLC, U.S. Govt. has certain rights
Health care professionals may use lab or imaging tests to diagnose pancreatitis and find its causes. Diagnosing chronic pancreatitis can be hard in the early stages. Your doctor will also test for other conditions that have similar symptoms, such as peptic ulcers or pancreatic cancer.
Lab tests to help diagnose pancreatitis include the following:
Blood tests. A health care professional may take a blood sample from you and send the sample to a lab to test for
Stool tests. Your doctor may test a stool sample to find out if a person has fat malabsorption.
Health care professionals also use imaging tests to diagnose pancreatitis. A technician performs most tests in an outpatient center, a hospital, or a doctor’s office. You don’t need anesthesia, a medicine to keep you calm, for most of these tests.
Ultrasound. Ultrasound uses a device called a transducer, which bounces safe, painless sound waves off your organs to create a picture of their structure. Ultrasound can find gallstones.
Computed tomography (CT) scan. CT scans create pictures of your pancreas, gallbladder, and bile ducts. CT scans can show pancreatitis or pancreatic cancer.
Magnetic resonance cholangiopancreatography (MRCP). MRCP uses a magnetic resonance imaging (MRI) machine, which creates pictures of your organs and soft tissues without x-rays. Your doctor or a specialist may use MRCP to look at your pancreas, gallbladder, and bile ducts for causes of pancreatitis.
Endoscopic ultrasound (EUS). Your doctor inserts an endoscope—a thin, flexible tube—down your throat, through your stomach, and into your small intestine. The doctor turns on an ultrasound attachment to create pictures of your pancreas and bile ducts. Your doctor may send you to a gastroenterologist to perform this test.
Pancreatic Function Test (PFT). Your doctor may use this test to measure how your pancreas responds to secretin, a hormone made by the small intestine. This test is done only at some centers in the United States.
Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Pancreatic Function Test
Also called: PFT, Secretin Stimulation, Secretin Endoscopic Pancreatic Function Test (ePFT)
This test measures how your pancreas responds to secretin, a hormone made by the small intestine when partially digested food is present. When secretin is given to you during this test, certain chemicals may be increased in your blood. This is measured during the test. This test is done to check the digestive function of the pancreas.
Amylase Test
Also called: Amy, Amylase
An amylase test is used to measure levels of amylase in the blood or urine. Amylase is an enzyme, found mainly in saliva and pancreatic fluid, that helps you digest food. Abnormal levels in blood or urine may indicate a disorder of the pancreas.
Chymotrypsin Test
Also called: Chymotrypsin in Stool, Fecal Chymotrypsin, Trypsin and Chymotrypsin Stool Test
This test measures the amount of chymotrypsin in a stool sample. Chymotrypsin is an enzyme released by the pancreas during digestion. If the amount is lower than normal, it may mean your pancreas isn't making enough enzymes to digest your food properly.
Abdominal Ultrasound
Also called: Ultrasound - abdomen, Abdominal sonogram, Abdominal sonography, Right upper quadrant sonogram, Ultrasound of the Abdomen, Ultrasound Imaging of the Abdomen
An abdominal ultrasound uses sound waves to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and kidneys. It may also be used to assess blood flow to abdominal organs. An abdominal ultrasound can help find the cause of stomach pain or bloating, check for kidney stones, liver disease, tumors and many other conditions.
Electrolytes
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Source: Genetic and Rare Diseases (GARD) Information Center
Treatment and Prognosis varies depending on the type of condition and the age of symptom onset.
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Source: Genetic and Rare Diseases (GARD) Information Center
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