MRCP Versus ERCP in the Evaluation of Chronic Pancreatitis in Children

Kołodziejczyk, Elwira; Jurkiewicz, Elżbieta; Pertkiewicz, Jan; Wejnarska, Karolina; Dądalski, Maciej; Kierkuś, Jarosław; Woynarowski, Marek; Ryżko, Józef; Oracz, Grzegorz

doi:10.1097/mpa.0000000000000644

Cited by 28 publications

(21 citation statements)

References 36 publications

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“…CT can detect advanced changes in CP, including calcifications, pancreas atrophy, fat replacement, but it has poor sensitivity to identify ductal abnormalities and subtle parenchymal changes. MRI/MRCP can reliably detect pancreas atrophy, ductal dilatations, small filling defects, strictures, irregularities of the main pancreatic duct, and irregularity of side branches 51 and it has become the diagnostic imaging method of choice in children 52 . Secretin may increase the detectability of the normally small pancreatic ducts on MRCP 53 .…”

Section: Acute Recurrent and Chronic Pancreatitismentioning

confidence: 99%

Pancreatic Disorders

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Fishman

2017

Pediatric Clinics of North America

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Synopsis Once considered uncommon, pancreatic diseases are increasingly recognized in the pediatric age group. Acute, acute recurrent and chronic pancreatitis occur in children with an incidence approaching that of adults. The risk factors in the pediatric age group are broad, prompting the need for a completely different diagnostic and therapeutic approach in children. Although cystic fibrosis is still the most common cause of exocrine pancreatic insufficiency, other causes such as chronic pancreatitis may be as common as Shwachman Diamond syndrome. Long-term effects of pancreatic diseases may be staggering as children suffer from significant disease burden, high economic cost, nutritional deficiencies, pancreatogenic diabetes and potentially pancreatic cancer.

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Section: Acute Recurrent and Chronic Pancreatitismentioning

confidence: 99%

Pancreatic Disorders

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Fishman

2017

Pediatric Clinics of North America

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“…The search for a genetic cause of CP should include a sweat chloride test and mutation analysis of the genes mentioned above 6. MRCP should be used as the imaging method of choice, but if the likelihood of therapeutic intervention is high, ERCP is the best option 7…”

Section: Discussionmentioning

confidence: 99%

Chronic pancreatitis in children: treat like an adult?

et al. 2019

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A 15-year-old boy with a medical background of obesity, familial hyperlipidemia and acute recurrent pancreatitis, presented to emergency department reporting a 3-day course of periumbilical abdominal pain and nausea. Pain was noticed on epigastric palpation. Laboratory evaluation revealed leucocytosis, neutrophilia and pancreatic enzymes elevation more than three times the upper limit of normal. An acute recurrence of pancreatitis was diagnosed, was admitted to the hospital, being discharged after 5 days. Four days after, he was readmitted because of symptoms recurrence. Elevation of transaminases, GGT and direct bilirubin were noticed. Pancreatic enzymes still elevated but lower than in the previous episode. An endoscopic ultrasound revealed a Wirsung with a cephalic stricture and diffuse structural abnormalities suggestive of chronic pancreatitis. The patients was submitted to endotherapy with several sessions of endoscopic retrograde cholangiopancreatography including stenting and pancreatoscopy with marked clinical and imaging improvement. A genetic variant was identified.

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“…Cambridge classification is used in ERCP for staging the CP, while its modified version is used in MRCP. 15 It depends on the status of MPD, number of side branches, presence of calculi, and ductal strictures.…”

Section: Endoscopic Retrograde Cholangiopancreatographymentioning

confidence: 99%

Imaging in Chronic Pancreatitis

Sood

Kandasamy

Sharma

2020

Journal of Gastrointestinal and Abdominal Radiology

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Chronic pancreatitis (CP) is a chronic progressive process which can cause irreversible damage to both the exocrine and endocrine systems of pancreas. There are various imaging modalities available to evaluate CP of which ultrasonography ( USG), computed tomography (CT), and magnetic resonance imaging (MRI) are most commonly used. USG is used as a screening modality which can show various changes of CP and its complications. However, the information obtained from USG can be limited because of the patient’s body habitus. CT is the workhorse modality which can provide comprehensive information and it is the best modality to detect calcification. MRI, on the other hand, is excellent in demonstrating the pancreatic parenchyma and the ductal system. Alcohol-related pancreatitis is the commonest cause which can show gland atrophy, ductal dilatation, and calcifications. Other less common causes include hereditary and genetic mutation–related pancreatitis. There are other special types of pancreatitis such as autoimmune pancreatitis and groove pancreatitis that have characteristic features on imaging.

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MRCP Versus ERCP in the Evaluation of Chronic Pancreatitis in Children

Abstract: Magnetic resonance cholangiopancreatography provides diagnostic information equivalent to ERCP in a large percentage of pediatric patients with CP and should be used as the imaging method of choice, especially if the likelihood of therapeutic intervention is low.

Cited by 28 publications

References 36 publications

Pancreatic Disorders

Pancreatic Disorders

Chronic pancreatitis in children: treat like an adult?

Imaging in Chronic Pancreatitis

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