Faculty Opinions recommendation of Risk of recurrent pancreatitis and progression to chronic pancreatitis after a first episode of acute pancreatitis.

Idiopathic acute recurrent pancreatitis (IARP) is defined as at least two episodes of acute pancreatitis with the complete or near-complete resolution of symptoms and signs of pancreatitis between episodes, without an identified cause. There is a paucity of information about the usefulness of endoscopic ultrasound (EUS) in IARP.ObjectivesTo determine the diagnostic yield of EUS in IARP.DesignA retrospective study was performed in patients with IARP evaluated by EUS between January 2009 and December 2016. Follow-up assessments of acute pancreatitis recurrence were carried out.ResultsSeventy-three patients with 102 EUS procedures were included. EUS was able to identify the cause of IARP in 55 patients (75.3%). The most common findings were chronic pancreatitis in 27 patients (49.1%), followed by lithiasic pathology in 24 patients (43.6%), and intraductal papillary mucinous neoplasm in four patients (7.3%). A directed treatment against EUS findings had a protective tendency associated with the final resolution of recurrence. There were no complications reported.ConclusionEUS performed in patients with IARP helped to identify a possible cause in 2/3 of the cases. The majority of patients have a treatable disease.

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

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.84748 ◽

2021 ◽

Author(s):

Ferda Özbay Hoşnut ◽

Gülseren Şahin ◽

Ayla Akça Çağlar ◽

Naz Güleray ◽

Derya Erdoğan

Keyword(s):

Acute Pancreatitis ◽

Chronic Pancreatitis ◽

Congenital Anomalies ◽

Clinical Laboratory ◽

Common Factor ◽

Hereditary Pancreatitis ◽

Recurrent Pancreatitis ◽

Common Causes ◽

Idiopathic Acute Pancreatitis ◽

Day By Day

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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Outcomes, risk of recurrence and chronic pancreatitis after a first episode of idiopathic acute pancreatitis: a retrospective cohort study

Pancreatology ◽

10.1016/j.pan.2019.07.008 ◽

2019 ◽

Vol 19 ◽

pp. S182

Author(s):

A. García García de Paredes ◽

E. Sánchez Rodríguez ◽

C. González Olivares ◽

E. Rodríguez de Santiago ◽

J. Martínez ◽

...

Keyword(s):

Acute Pancreatitis ◽

Cohort Study ◽

Chronic Pancreatitis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

First Episode ◽

Risk Of Recurrence ◽

Idiopathic Acute Pancreatitis

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Endoscopic management of recurrent pancreatitis

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.95034 ◽

2012 ◽

Vol 03 (S 05) ◽

pp. 056-057

Author(s):

Glen A. Lehman

Keyword(s):

Acute Pancreatitis ◽

Chronic Pancreatitis ◽

Biliary Tract ◽

Endoscopic Sphincterotomy ◽

Endoscopic Therapy ◽

Endoscopic Management ◽

Gallstone Pancreatitis ◽

Recurrent Pancreatitis ◽

Valuable Alternative ◽

Relative Safety

AbstractEndoscopic therapy is a well-established, valuable alternative to surgery for the treatment of a variety of biliary tract diseases. Applications of similar techniques to the pancreas continue to develop. Encouraged by the recognition of the relative safety of ERCP and endoscopic sphincterotomy (ES) for gallstone pancreatitis, endoscopic therapy is now being applied in the setting of acute pancreatitis of other etiologies, chronic pancreatitis, complications of acute or chronic pancreatitis, and pancreas divisum.

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The Evaluation of Acute Pancreatitis into Acute Recurrent Pancreatitis in Children: The Impact of Etiological Factors

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol06-i11/1261 ◽

2021 ◽

Vol 6 (11) ◽

pp. 766-771

Author(s):

Anna Kofla-Dlubacz, M.D., Ph.D. ◽

Tatiana Jamer M.D. ◽

Katarzyna Akutko M.D., Ph.D. ◽

Tomasz Pytrus M.D., Ph.D. ◽

Barbara Iwańczak M.D., Ph.D. ◽

...

Keyword(s):

Acute Pancreatitis ◽

Pediatric Population ◽

Clinical Problem ◽

First Episode ◽

Recurrent Pancreatitis ◽

Predisposing Factor ◽

Etiological Factors ◽

Morbidity Risk ◽

Medical University ◽

The Impact

Background: The incidence of acute pancreatitis (AP), acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) in pediatric population is rising and becomes common clinical problem in gastroenterology. The assessment of morbidity risk factors is necessary to improve the quality of diagnosis, to determine further treatment and to identify groups with poor prognosis of the evolution of AP into ARP and CP. Objectives: The assessment of etiological factors in acute and acute recurrent pancreatitis in children. Material and methods: From January 2015 to November 2017, data on etiological factors responsible for the onset of AP and ARP were collected in a group of pediatric patients hospitalized at the Department of Paediatrics, Gastroenterology and Nutrition, Medical University of Wroclaw, Poland. The study group consisted of 39 patients (27 patients with AP, 11 patients with ARP and 1 with CP). Results: The potential etiological factor was established in 85.2% of children with AP and in 100% of children with ARP. Mutations in the SPINK1 gene were found in 44.4% of children from the ARP group, no mutations in the PRSS1 gene were found in this group. In all patients with a genetic predisposition (SPINK1 mutation) during the first episode of the ARP, coexistence of an additional predisposing factor was found. Conclusions: Patients with ARP require diagnostics towards mutations predisposing to the transition of AP into a chronic disease. The interaction of additional triggers plays a role in the development of pancreatitic inflammatory disease in genetically predisposed individuals.

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Pancreatitis in Pre-Adolescent Children

10.21203/rs.2.10728/v1 ◽

2019 ◽

Author(s):

Melanie Randall ◽

Sarah McDaniels ◽

Kristina Kyle ◽

Meina Michael ◽

Lance Brown

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Acute Pancreatitis ◽

Chronic Pancreatitis ◽

Descriptive Statistics ◽

Unknown Etiology ◽

Structural Factors ◽

Recurrent Pancreatitis ◽

Imaging Results ◽

Emergency Department Patients

Abstract Background Pediatric pancreatitis is increasing, whether due to an increase in cholelithiasis or factors such as increased awareness and testing. This study was to describe previously undescribed pre-adolescent children with pancreatitis to illuminate this population and clarify who should be screened for pancreatitis. Methods This is a descriptive retrospective study of emergency department patients <13 years old over 10 years with the diagnosis of pancreatitis. Demographics, laboratory values, imaging results and final diagnoses/etiologies were recorded and evaluated using descriptive statistics. Results 100 patients presented with acute pancreatitis and median age of 8 years (IQ range 5-11). 25% were attributed to an unknown etiology. 16 were medication induced, 13 genetic/congenital/structural, 14 traumatic/post surgical, 14 had gallstones, and 17 had autoimmune or systemic illness-related pancreatitis. 29 patients had recurrent pancreatitis. Conclusions Cholelithiasis is a much less frequent etiology in children than in adults. Genetic/structural factors represent a larger proportion of acute cases and higher proportion of recurrent pancreatitis. Concurrent systemic and viral illnesses are more common than in adults. Patients on pancreatitis-causing medications or with known genetic/structural issues should be tested for pancreatitis. Patients without risk factors rarely developed recurrent pancreatitis. Hypertriglyceridemia was not found to be an etiology. Chronic pancreatitis was uncommon.

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Haemoconcentration as a predictor of severity in acute pancreatitis

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v4i1.15020 ◽

2016 ◽

Vol 4 (1) ◽

pp. 3-7

Author(s):

Tanka Prasad Bohara ◽

Dimindra Karki ◽

Anuj Parajuli ◽

Shail Rupakheti ◽

Mukund Raj Joshi

Keyword(s):

Acute Pancreatitis ◽

Pearson Correlation ◽

Characteristic Curve ◽

Scoring Systems ◽

Cost Effective ◽

Receiver Operator Characteristic Curve ◽

First Episode ◽

P Value ◽

Receiver Operator Characteristic ◽

Chi Square

Background: Acute pancreatitis is usually a mild and self-limiting disease. About 25 % of patients have severe episode with mortality up to 30%. Early identification of these patients has potential advantages of aggressive treatment at intensive care unit or transfer to higher centre. Several scoring systems are available to predict severity of acute pancreatitis but are cumbersome, take 24 to 48 hours and are dependent on tests that are not universally available. Haematocrit has been used as a predictor of severity of acute pancreatitis but some have doubted its role.Objectives: To study the significance of haematocrit in prediction of severity of acute pancreatitis.Methods: Patients admitted with first episode of acute pancreatitis from February 2014 to July 2014 were included. Haematocrit at admission and 24 hours of admission were compared with severity of acute pancreatitis. Mean, analysis of variance, chi square, pearson correlation and receiver operator characteristic curve were used for statistical analysis.Results: Thirty one patients were included in the study with 16 (51.61%) male and 15 (48.4%) female. Haematocrit at 24 hours of admission was higher in severe acute pancreatitis (P value 0.003). Both haematocrit at admission and at 24 hours had positive correlation with severity of acute pancreatitis (r: 0.387; P value 0.031 and r: 0.584; P value 0.001) respectively.Area under receiver operator characteristic curve for haematocrit at admission and 24 hours were 0.713 (P value 0.175, 95% CI 0.536 - 0.889) and 0.917 (P value 0.008, 95% CI 0.813 – 1.00) respectively.Conclusion: Haematocrit is a simple, cost effective and widely available test and can predict severity of acute pancreatitis.Journal of Kathmandu Medical College, Vol. 4(1) 2015, 3-7

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Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model

Scientific Reports ◽

10.1038/s41598-020-80532-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Péter J. Hegyi ◽

Alexandra Soós ◽

Emese Tóth ◽

Attila Ébert ◽

Viktória Venglovecz ◽

...

Keyword(s):

Acute Pancreatitis ◽

Chronic Pancreatitis ◽

Morphological Changes ◽

International Study ◽

Study Data ◽

Cross Sectional ◽

Clinical Biomarkers ◽

Stage Disease ◽

Significant Difference ◽

End Stage

AbstractChronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.

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