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Beneficial use of an evocative test in chronic relapsing pancreatitis in children

W L Buntain, E Buonocore, S A Royal

    American Journal of Surgery
    |December 1, 1986
    PubMed

    Insights

    Diagnosing chronic recurrent pancreatitis in children is challenging. The morphine-prostigmine pancreatic evocative test, combined with ultrasonography, helps identify children with abdominal pain who may benefit from surgical intervention.

    Area of Science:

    • Pediatric Gastroenterology
    • Diagnostic Medicine

    Background:

    • Chronic recurrent pancreatitis in children is poorly understood, with unclear incidence, natural history, and diagnostic challenges.
    • Chronic recurrent abdominal pain is a common pediatric complaint, necessitating investigation into its underlying causes.

    Purpose of the Study:

    • To evaluate the utility of the morphine-prostigmine pancreatic evocative test combined with ultrasonography in diagnosing chronic recurrent pancreatitis in children presenting with abdominal pain.
    • To assess the effectiveness of surgical interventions in children with positive diagnostic test results.

    Main Methods:

    • Utilized the morphine-prostigmine pancreatic evocative test and pancreatic ultrasonography to assess pancreatic ductal activity in 67 children with chronic recurrent abdominal pain.
    • Performed surgical procedures, including partial pancreatectomies and sphincteroplasties, on 13 patients with positive test results.

    Main Results:

    • Fourteen out of 67 children exhibited positive results on the diagnostic tests.
    • Of the 13 surgically treated patients, 7 became asymptomatic, and 5 showed significant improvement. One patient who underwent pancreatography only continued to experience pain.
    • One patient awaiting surgery also continues to experience pain.

    Conclusions:

    • The morphine-prostigmine test, augmented by ultrasonography, is a valuable tool for identifying pediatric patients with abdominal pain potentially caused by pancreatitis.
    • Surgical intervention appears beneficial for selected children diagnosed with chronic recurrent pancreatitis using this method.

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