Related Experiment Video
Updated: Jun 24, 2025
Preparing a Mice Model of Severe Acute Pancreatitis via a Combination of Caerulein and Lipopolysaccharide Intraperitoneal Injection
Published on: May 10, 2024
Acute pancreatitis in children with inflammatory bowel disease: Risk factors, clinical course, and prognosis
Adi Anafy1,2, Yehoshua Mirkin2, Tut Galai1,2
1The Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Insights
Pediatric patients with inflammatory bowel disease (IBD) experiencing acute pancreatitis (AP) typically have mild cases. IBD-associated arthritis is a risk factor for AP, but IBD medications are not.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Pancreatology
Background:
- Acute pancreatitis (AP) is a significant concern in pediatric patients.
- Understanding AP in the context of inflammatory bowel disease (IBD) is crucial for comprehensive care.
- Previous research has not fully elucidated the specific characteristics and risk factors of AP in pediatric IBD patients.
Purpose of the Study:
- To compare the clinical course of AP in children with and without IBD.
- To identify risk factors associated with AP development specifically within the pediatric IBD population.
Main Methods:
- Retrospective, single-center study of hospitalized children (<19 years) with AP from 2005-2019.
- Comparison of clinical characteristics between AP patients with and without IBD.
- Risk factor analysis for AP development in pediatric IBD patients.
Main Results:
- AP in pediatric IBD patients was mild, with lower amylase levels and no need for invasive intervention compared to non-IBD patients.
- IBD-associated arthritis was identified as a significant risk factor for AP development in IBD patients (23% vs. 3%).
- Extracolonic Crohn's disease and nutritional induction therapy were found to be negative risk factors for AP.
Conclusions:
- The clinical course of AP in pediatric IBD patients is generally mild.
- IBD-associated arthritis is a key risk factor for AP in this population.
- Unexpectedly, IBD medications were not found to be a risk factor for AP in pediatric IBD patients.
Objectives:
To characterize the clinical course of acute pancreatitis (AP) in pediatric inflammatory bowel disease (IBD) patients compared to children with AP without IBD and to identify risk factors associated with AP among IBD patients.
Methods:
This retrospective, single-center study compared clinical characteristics of children (<19 years) with AP with and without concomitant IBD who were hospitalized 2005-2019. We also conducted a risk factor analysis of AP development in pediatric IBD.
Results:
Sixty-eight (54% males) patients with 120 episodes of AP were admitted at a median age of 15.3 years. Thirteen patients (14 episodes) had a co-diagnosis of IBD, representing 4% of our IBD patient population. The AP-IBD patients presented with lower amylase levels compared to the non-IBD patients (160 [interquartile range, IQR: 83-231] vs. 418 [IQR: 176-874] U/L, p > 0.01), all had a mild pancreatitis, and none required invasive intervention. The presumed etiology for AP in all IBD patients was IBD-related: IBD flare-up in five, side effects of medications in two, and undetermined in seven. The only risk factor for AP development among IBD patients was IBD-associated arthritis (23% vs. 3% for IBD-non-AP, p = 0.04), while extracolonic Crohn's disease and induction therapy with nutrition were negative risk factors (15% vs. 51%, p = 0.05, and 8% vs. 44%, p = 0.04, respectively). Other parameters, including disease type and medications, were nonsignificant.
Conclusion:
The clinical course of AP in pediatric IBD patients is mild. Only IBD-associated arthritis emerged as a risk factor for the development of AP, while, unexpectedly, IBD medication did not.
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:22Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...