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Role of Pancreatic Divisum in Pediatric Pancreatitis: A Retrospective Observational Study
Kunhimoole Keshava Pavan1, Raghunath Bangalore Vasudev1, Veerabhadra Radhakrishna1
1Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Insights
Pancreatic divisum (PD) in children with pancreatitis is linked to earlier onset and a higher risk of acute recurrent pancreatitis (ARP). This finding suggests PD is a significant cause of pediatric pancreatitis.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Research
Background:
- Pancreatic divisum (PD) is a congenital anomaly of the pancreatic duct system.
- The role of PD in pediatric pancreatitis remains incompletely understood.
- Early identification of risk factors for pediatric pancreatitis is crucial.
Purpose of the Study:
- To evaluate the association between pancreatic divisum (PD) and pancreatitis in pediatric patients.
- To compare the clinical characteristics of children with pancreatitis with and without PD.
Main Methods:
- Retrospective observational study at a pediatric surgery tertiary center.
- Inclusion of children under 18 years presenting with pancreatitis (January 2013 - June 2024).
- Comparison of PD pancreatitis group versus non-PD pancreatitis group.
Main Results:
- 15 out of 275 children (5.5%) had PD, predominantly Type 1.
- Children with PD pancreatitis presented at a younger age (9.8 vs. 12.2 years).
- Significantly higher incidence of acute recurrent pancreatitis (ARP) in the PD group (60% vs. 22%).
Conclusions:
- Children with PD experience pancreatitis at a younger age.
- PD is associated with an increased risk of developing ARP.
- PD is suggested as an independent etiological factor for pediatric pancreatitis.
Aim:
The aim of the study was to evaluate the role of pancreatic divisum (PD) in children with pancreatitis.
Methods:
A retrospective observational study was conducted at a pediatric surgery tertiary center which included children aged <18 years who presented with pancreatitis between January 2013 and June 2024. The children with pancreatitis having PD (PD pancreatitis group) were compared to the children with pancreatitis not having PD (non-PD pancreatitis group).
Results:
A total of 275 children with pancreatitis were included in the study and 15 (5.5%) of them had PD. Type 1 (Classical) PD was seen in 11 (69%) of the children and nine (60%) children presented with acute recurrent pancreatitis (ARP). The children with PD pancreatitis presented at a younger age (9.8 ± 4.3 years vs. 12.2 ± 3.7 years; P = 0.02; independent sample t-test) and tend to have a significantly higher incidence of ARP (9 [60%] vs. 58 [22%]; P < 0.001; Chi-square test) compared to the children with non-PD pancreatitis.
Conclusion:
Children with PD present at a younger age with pancreatitis and are at increased risk of developing ARP. This suggests that PD is an independent etiology for developing pancreatitis in children.
