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Acute pancreatitis in children: Updates in epidemiology, diagnosis and management
1Boonshoft School of Medicine, Wright State University, Associate Chief Medical Officer, Physician Lead, Patient and Family Experience, Dayton Children's Hospital.
Insights
Pediatric acute pancreatitis (AP) is rising, but its natural history and long-term effects are unclear. Early diagnosis and management by primary care clinicians are crucial for children with AP.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pediatrics
Background:
- Acute pancreatitis (AP) is increasingly diagnosed in children due to enhanced awareness and diagnostic tools.
- The natural history and long-term implications of severe acute pancreatitis (SAP) in pediatric populations remain poorly understood.
- Gaps exist in the current understanding and management strategies for pediatric AP.
Purpose of the Study:
- To provide guidelines on the epidemiology, diagnosis, and management of acute pancreatitis in children.
- To address the gaps in knowledge regarding the natural history and long-term outcomes of pediatric AP.
- To highlight the critical role of primary care clinicians in the early identification and management of pediatric AP.
Main Methods:
- Literature review focusing on epidemiology, diagnosis, and management of pediatric acute pancreatitis.
- Synthesis of current evidence to formulate clinical guidelines.
- Analysis of diagnostic capabilities and their impact on AP recognition.
Main Results:
- Increased recognition of pediatric AP driven by improved diagnostics and awareness.
- Persistent lack of understanding regarding the natural history and long-term sequelae of AP, particularly SAP.
- Critical need for primary care involvement in early diagnosis and initial management.
Conclusions:
- Guidelines are needed to standardize the approach to pediatric AP.
- Further research is required to elucidate the long-term implications of severe AP in children.
- Enhanced primary care clinician education can improve early AP management and optimize sub-specialist consultation.
Abstract:
Acute pancreatitis (AP), manifesting as acute onset of abdominal pain, vomiting, and nausea, is increasingly being recognized in children secondary to increased awareness, more identifiable etiologies as well as advances in diagnostic capabilities, like imaging. Despite this increased awareness and ability for more frequent diagnoses, the natural history of AP remains poorly understood leading to gaps in approach and management, especially in children. Coupled with poor epidemiologic and management awareness, there remains a lack of understanding of the long term implications of severe acute pancreatitis (SAP). Hence, the role of the primary care clinician in the early diagnosis, and management, remains critical and may affect the need for consultation with pediatric sub-specialists like gastroenterologists. This review provides guidelines regarding epidemiology, diagnosis, and management strategies to address some of these gaps.
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