Is acute recurrent pancreatitis in children a precursor of chronic pancreatitis? A long-term follow-up study of 93 cases

Poddar, Ujjal; Yachha, Surender Kumar; Borkar, Vibhor; Srivastava, Anshu

doi:10.1016/j.dld.2017.02.019

Cited by 19 publications

(14 citation statements)

References 33 publications

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“…Despite the hypotheses stating that recurrent acute pancreatitis attacks may turn into CP, there are no data on the conversion of ARP to CP in children, excepting possibly the cases with hereditary pancreatitis (16) . Poddar et al (17) reported that 37 (42%) of 88 children with ARP developed CP and therefore, ARP is the precursor of the chronic process and chronicity is associated with idiopathic etiology and genetic mutations. Our study supports this thought as 29.16% of our patients with ARP developed chronic pancreatitis and recurrent attacks were the precursors of a chronic pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis and Acute Recurrent Pancreatitis: Investigation of Clinical and Etiological Factors

Hoşnut¹,

Şahin²,

Çağlar³

et al. 2021

BUCH

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INTRODUCTION: It was aimed to evaluate the etiology, clinical, laboratory and imaging findings and treatment methods of patients who have admitted with acute pancreatitis (AP) and progressed to chronic pancreatitis (CP) with ARP (acute recurrent pancreatitis). METHODS: The data of children under the age of 18 years who were admitted to our hospital between January 2013-July 2020 and were diagnosed with acute, acute recurrent or chronic pancreatitis according to INSPPIRE diagnostic criteria were evaluated retrospectively. RESULTS: There were 77 patients who were followed-up with the diagnosis of acute pancreatitis. Pancreatitis attack did not recur in 53/77 patients and no underlying cause was found in 35.84% (19/53) of the patients. The most common factor in those whose cause could be determined was gallstones (15.1%) (8/53). The pancreatitis attack recurred in 24 (31%) of the patients. Congenital anomalies (9/24) and hereditary pancreatitis (5/24) were the most common causes of pancreatitis in these patients and these factors were a risk factor for the recurrence of pancreatitis attack. There was no difference between the groups in terms of complications (p=0.423); however, chronicity was more common in the group with ARP (p=0.003). DISCUSSION AND CONCLUSION: Beside the pancreatitis is a rare disease in childhood, with the increase of awareness and increased accessibility to diagnostic imaging methods, more and more pancreatitis is diagnosed day by day. Idiopathic acute pancreatitis cases still constitute the largest group. If other causes are excluded in these cases, it is important to investigate congenital anomalies, genetic and metabolic etiologies

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Section: Discussionmentioning

confidence: 99%

Acute Pancreatitis and Acute Recurrent Pancreatitis: Investigation of Clinical and Etiological Factors

Hoşnut¹,

Şahin²,

Çağlar³

et al. 2021

BUCH

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“…In this sense radiology plays an important role, allowing to identify the causes early and treat them promptly, improving the patient's outcome. In fact, the idiopathic forms of acute pancreatitis, those without an apparent underlying cause that can be treated, have a significantly worse outcome [15].…”

Section: Recurrent Acute Pancreatitismentioning

confidence: 99%

Imaging of Pancreatitis

Morana¹,

Beleù²,

Nistri³

et al. 2023

Multidisciplinary Management of Acute and Chronic Pancreatitis

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Imaging of pancreatitis is very complicated. Correct detection of the various forms of pancreatitis is essential for adequate early therapy. In acute pancreatitis, imaging is useful for diagnosis, but above all for the research of causes and any complications. In autoimmune forms, imaging raises clinical suspicion and guides the response to therapy and the search for associated pathologies. In chronic pancreatitis, imaging is essential for grading, differential diagnosis with neoplastic diseases and follow-up. The classical CT and MRI methods play a fundamental role in this sense, being increasingly supported by modern special techniques such as S-MRCP and T1-mapping. Finally, interventional radiology today represents one of the main minimally invasive methods for the diagnosis and treatment of complications.

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“…[3][4][5][6] Recent pediatric studies showed genetic and idiopathic as most common etiology of ARP and none of the patients had hyperparathyroidism as a risk factor of ARP in their series. 2,8 Hypercalcemia as one of the metabolic disturbance in primary hyperparathyroidism accelerates intra-pancreatic conversion of trypsinogen to trypsin which causes the pancreatic damage. In hyperparathyroidism associated pancreatitis acute management of pancreatitis episodes remain same but once acute attack resolves, patients should undergo elective parathyroidectomy to definitively treat the primary hyperparathyroidism.…”

Section: Case Reportmentioning

confidence: 99%