The Diagnostic and Therapeutic Role of Endoscopic Retrograde Cholangiopancreatography in Children

Brown, Christopher; Werlin, Steven L.; Geenen, Joseph E.; Schmalz, Michael J.

doi:10.1097/00005176-199307000-00003

Cited by 69 publications

(45 citation statements)

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“…This technique requires radiologic support and is limited in use to older children [8]. Patients experiencing repeated attacks should undergo ERCP to exclude an anatomical cause, provided other metabolic causes are not present.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of pancreatitis was made in those patients who showed: (1) significant intra-operative pathology or; (2) clinical findings of pancreatic inflammation and laboratory confirmation. More than one third (16 cases) of the cases were due to trauma, other causes included systemic disease (10), structural disease (8), and toxins or drugs (4), Five cases were classified as idiopathic. Most of the patients presented with abdominal pain (95%) and vomiting (56%).…”

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confidence: 99%

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Pancreatitis in children —experience with 43 cases

et al. 1996

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Pancreatitis in children —experience with 43 cases

et al. 1996

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“…In older children, the success rate for cannulation of the desired duct is 97-98% comparable to that achieved in adults [1][2][3][4][5][11][12][13][14][15][16][17][18]. Our ERCP success in 220 children older than 1 year was 98%.…”

Section: Pancreatic Indicationsmentioning

confidence: 52%

“…It was found in children with recurrent pancreatitis [2,11,55]. These patients are generally treated by standard biliary sphincterotomy and, in general, they do not respond well [14] presumably because the pancreatic sphincter is not transected.…”

Section: Sphincter Of Oddi Dysfunctionmentioning

confidence: 99%

ERCP in children

Guelrud

Gelrud

2014

Ercp

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“…Recently, endoscopic dilatation or sphincterotomy and stenting have been used with increasing frequency, even in children. 19 The difficulties of performing these procedures in the small ducts encountered in children have proven to be a limiting factor. In our group of patients, the minor papilla could be cannulated for pancreatography in only 38% of patients.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Recurrent Pancreatitis in Children With Pancreas Divisum

Neblett

O’Neill

2000

Annals of Surgery

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ObjectiveTo analyze an institutional experience with pancreatitis in childhood to clarify the frequency of pancreas divisum in that patient population, the characteristics of pancreatitis in children with pancreas divisum, and the role of surgical management in their treatment. Summary Background DataThe role of pancreas divisum in causing acute and relapsing pancreatitis and chronic, recurring abdominal pain is controversial. Although the anatomical abnormality is present from birth, most investigators have reported cases with onset of symptoms in adulthood. The reported pediatric experience with this disorder is small, and the natural history of pancreatitis in children with pancreas divisum has not been well elucidated. MethodsA retrospective chart review of all children 18 years of age and younger with a discharge diagnosis of pancreatitis identified 135 patients treated in the authors' institution from 1978 to 1998. Ten patients were found to have anatomical variants of pancreas divisum associated with recurrent or chronic pancreatitis. The medical records of these patients were reviewed for data on the presentation, diagnostic findings, imaging studies, treatment, surgical findings, and pathologic findings in these children. Chart review and telephone calls were used to assess the current state of health in nine patients available for follow-up. ResultsPancreas divisum was identified in 7.4% of all children with pancreatitis and 19.2% of children with relapsing or chronic pancreatitis. Patients had early onset of recurrent episodic epigastric pain and vomiting, at a mean age of 6 years. Three patients had a positive family history of pancreatitis and one was proven by DNA analysis to have hereditary pancreatitis. Pancreatitis was documented by elevated amylase or lipase levels, and endoscopic retrograde cholangiopancreatography was the method of diagnosis of pancreas divisum in all patients. Eight patients had complete pancreas divisum and two had incomplete variants. Eight patients underwent surgery to improve ductal drainage. Seven underwent transduodenal sphincteroplasty of the accessory papilla, along with sphincteroplasty of the major papilla in two (plus septoplasty in one). Three patients underwent longitudinal pancreaticojejunostomy, as a primary procedure in one patient with midductal stenosis and in two because of recurring pancreatitis after sphincteroplasty. The surgical findings and histologic examination of five patients undergoing distal pancreatectomy revealed striking changes of advanced chronic pancreatitis. Patients responding to sphincteroplasty alone showed less severe histologic changes. Overall, three of seven patients had excellent results, three were improved, and one had continued disabling attacks of pancreatitis. The mean duration of follow-up was 7.3 years, and there were no deaths. No patients had endocrine or exocrine pancreatic insufficiency, and none required chronic analgesics. ConclusionsPancreas divisum is an important cause of recurrent pancreatitis in childhood and sho...

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The Diagnostic and Therapeutic Role of Endoscopic Retrograde Cholangiopancreatography in Children

Cited by 69 publications

References 0 publications

Pancreatitis in children —experience with 43 cases

Pancreatitis in children —experience with 43 cases

ERCP in children

Surgical Management of Recurrent Pancreatitis in Children With Pancreas Divisum

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