Normal and abnormal pancreas in children: US studies.

Abstract

The real-time ultrasound images of the pancreas in 273 children without pancreatic disease were prospectively analyzed to determine the normal appearance of the pancreas. The dimensions of the head, body, and tail of the pancreas were correlated with patient age, weight, height, and body surface area. Correlation between pancreatic dimensions and patient age was as good as or better than that obtained with the other physical parameters. In general, the normal pancreas had a similar sized head and tail with a thinner body as compared with the abnormal pancreas, and an echogenicity that was equal to or slightly greater than that of the liver. Analysis of the images of 13 patients with pancreatitis showed that the presence of a dilated main pancreatic duct was the most useful feature in suggesting an abnormality. Evaluation of pancreatic size, configuration, and echogenicity was not reliable in the differentiation of the normal from the abnormal pancreas.

Acute pancreatitis in pediatrics: a systematic review of the literature

“…Algumas características facilitam a avaliação pela US em crianças quando comparadas a adultos, como menor tamanho do paciente, menor panículo adiposo e proeminência do lobo hepático esquerdo. Em estudos com adultos, a US tem cerca de 65% de sensibilidade para o diagnóstico de PA. Na maioria dos casos de PA, o pâncreas apresenta-se aumentado de tamanho e hiperecogênico em relação ao fígado; entretanto, como este é o aspecto normal do órgão inclusive em pacientes sem PA, esse dado não é relevante no diagnóstico 62 . Outras alterações podem incluir aumento no diâmetro do corpo do pâncreas e dos ductos pancreáticos 63 .…”

Acute pancreatitis associated to the use of valproic acid

“…An ultrasound is useful at the preliminary evaluation of patients suspected of having acute pancreatitis, and it must be done within the first 24 to 48 hours from the onset of the clinical symptoms. Thus, ultrasonography of the pancreatic duct is valuable in diagnosis and monitoring of pancreatitis in children 22 . An abdominal CAT must be performed on every patient with serious acute pancreatitis, as it plays a very important role in the diagnosis to assess the extent of the inflammatory process, the presence of macroscopic necrosis and the existence of pseudocysts or tumors, which were not detected in our patient.…”

Pediatric pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

“…Az akut pancreatitis diagnosztikus jellegzetességei, a parenchymaelváltozások, oedema és a peripancreaticus folyadékgyülem jól vizsgálhatóak ultrahanggal. A gyermekek többségében (56-84%) végeznek hasi ultrahangvizsgálatot akut pancreatitis gyanúja esetén [5,21]. Közlemények alapján a betegek harmadában-felében találtak pancreatitisre utaló eltérést ultrahanggal [10,21].…”

“…Az endoszkóp méreteit, technikai feltételeket fi gyelembe véve a vizsgálat 5 éves kortól végezhető speciális indikációval: epeúti kövesség megítélésére és a szövődmények (pseudocystadrenázs, finomtű-aspirációs mintavétel) kezelésében alkalmazható [21,25,26]. …”

“…A hasnyálmirigy legnagyobb ütemben az első életévben növekszik, de ez is nagy egyéni különb-séget mutat. Csecsemő-és kisdedkorban a hasnyálmirigy mérete nem teszi lehetővé a krónikus pancreatitis jelenlétének meghatározását [21,25].…”