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Gallstone pancreatitis in adolescents.
1Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, NY 10457.
Journal of Pediatric Surgery
|October 1, 1987
Summary
Gallstone pancreatitis is uncommon in adolescents but crucial to diagnose for abdominal pain. Surgical management, including cholecystectomy and intraoperative cholangiogram, is curative for gallstone disease.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Hepatobiliary Surgery
Background:
- Gallstone disease diagnosis in adolescents is infrequent.
- Acute pancreatitis in adolescents necessitates considering gallstone disease.
Observation:
- During a 5-year period, 18 adolescent patients were admitted with gallstone disease.
- Four of these patients presented with associated acute pancreatitis.
Findings:
- Common mechanisms include impacted stones, ampullary congenital pathology, and small stones in the common bile duct.
- Management involves cholecystectomy and intraoperative cholangiogram; sphincterotomy/sphincteroplasty should be avoided in adolescents.
Implications:
- Early diagnosis and appropriate surgical intervention, avoiding sphincterotomy, lead to curative outcomes.
- Gallstone pancreatitis is a critical differential diagnosis for upper abdominal pain in pediatric patients with gallstones.