Incidence of exocrine pancreatic insufficiency after acute pancreatitis: systemic review and meta-analysis

A 14-year-old child treated with valproic acid over several years for a seizure disorder developed abdominal pain with radiological evidence of acute pancreatitis. The association with valproic acid was not recognized, and the child continued to take the drug. The patient eventually developed steatorrhea and weight loss that improved with pancreatic enzyme replacement. Radiological evaluation showed an atrophic pancreas. Without evidence of other etiological factors, valproic acid by itself appeared to be the cause of chronic pancreatitis with exocrine pancreatic insufficiency in this patient.

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Exocrine Pancreatic Insufficiency in Adult Celiac Sprue: Systematic Evaluation of 31,434 Cases with Meta-analysis

The American Journal of Gastroenterology ◽

10.14309/00000434-201310001-00307 ◽

2013 ◽

Vol 108 ◽

pp. S92

Author(s):

Nirmal Mann ◽

Asha Gupta

Keyword(s):

Meta Analysis ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Systematic Evaluation ◽

Celiac Sprue

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Acute Pancreatitis Complicated with Choledochal Duct Rupture

Case Reports in Gastrointestinal Medicine ◽

10.1155/2011/413268 ◽

2011 ◽

Vol 2011 ◽

pp. 1-3

Author(s):

M. Bouvry ◽

K. Van Renterghem ◽

A. Verrijckt ◽

P. Smeets ◽

V. Meersschaut ◽

...

Keyword(s):

Acute Pancreatitis ◽

Genetic Factors ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Rare Clinical Entity ◽

Hereditary Pancreatitis ◽

Recurrent Acute Pancreatitis ◽

Ductus Choledochus ◽

Cationic Trypsinogen ◽

Familial Context

Recurrent acute pancreatitis is a rare clinical entity in childhood with unknown incidence (Rosendahl et al., 2007) and often occurring in a familial context. Genetic factors such as PRSS1 mutations (cationic trypsinogen gene) can be found in some patients. However, many remain idiopathic. The natural history remains poorly documented and the most frequent complications reported are pain, exocrine pancreatic insufficiency, diabetes mellitus, and pancreatic adenocarcinoma after long-standing hereditary pancreatitis. We describe a patient with hereditary pancreatitis in whom a mild pancreatitis episode was complicated by a perforation of the ductus choledochus.

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Acute pancreatitis prevalence in children with cystic fibrosis and PIP score prediction applicability

Romanian Journal of Medical Practice ◽

10.37897/rjmp.2021.2.23 ◽

2021 ◽

Vol 16 (2) ◽

pp. 248-253

Author(s):

Valentina-Daniela COMĂNICI ◽

◽

Ioana Florentina CODREANU ◽

Anca BĂLĂNESCU ◽

Alina Angelica BELIVACĂ ◽

...

Keyword(s):

Cystic Fibrosis ◽

Acute Pancreatitis ◽

Abdominal Pain ◽

Retrospective Study ◽

Pediatric Population ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Substitution Therapy ◽

Imaging Evaluation ◽

Female Predominance

One of the affected organs in cystic fibrosis (CF) is the pancreas, mainly translated into exocrine pancreatic insufficiency. Although rare, acute pancreatitis (AP) has been described, mostly in pancreatic sufficient patients. Objectives. Estimating AP prevalence in CF pediatric population of the I.N.S.M.C. „AlessandrescuRusescu” CF centre. Material and methods. 5 year retrospective study (2011-2016) including INSMC CF centre pediatric population aged 3-18 years. PA diagnosis was established on the presence of minimum 2 criteria between: characteristic abdominal pain, x3 normal value for age elevation of amylase/lipase, medical imaging evaluation suggestive for AP. Patients were evaluated with different criteria including PIP score of predicting AP risk. Outcomes. 48 patients were included with a slight female predominance (54%). 3 of them presented diagnostic criteria for AP (6,25%), all heaving pancreatic insufficiency and high PIP score (low risk of developing AP); 2 of them have low compliance with pancreatic enzymes substitution therapy; one of them presented recurrent episodes of AP. Conclusions. AP is a rare CF complication. It can be easily missed due to a large number of abdominal pain and emesis causes in CF patients. Although it is usually associated with pancreatic sufficiency, all our patients were pancreatic insufficient.

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Pancreatic involvement in inflammatory bowel disease: a review

Herald of Pancreatic Club ◽

10.33149/vkp.2019.03.02 ◽

2019 ◽

Vol 44 (3) ◽

pp. 23-32

Author(s):

F. S. Fousekis ◽

V. I. Theopistos ◽

K. H. Katsanos ◽

D. K. Christodouloua

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Acute Pancreatitis ◽

Bowel Disease ◽

Pancreatic Insufficiency ◽

Exocrine Pancreatic Insufficiency ◽

Pancreatic Diseases ◽

Pancreatic Involvement ◽

Multisystemic Disease ◽

Inflammatory Bowel

Inflammatory bowel disease (IBD) is a multisystemic disease, and pancreatic manifestations of IBD are not uncommon. The incidence of several pancreatic diseases in Crohn’s disease and ulcerative colitis is more frequent compared to the general population. Pancreatic manifestations in IBD include a wide heterogenic group of disorders and abnormalities of the pancreas and range from mild self-limited diseases to severe disorders. Acute pancreatitis, chronic pancreatitis, autoimmune pancreatitis, pancreatic autoantibodies, exocrine pancreatic insufficiency and asymptomatic imaging and laboratory abnormalities are included in related-IBD pancreatic manifestations. Involvement of the pancreas in IBD may be the result of IBD itself or of medications used.

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