Pancreatitis: evaluation with MR cholangiopancreatography in children

To determine the usefulness of magnetic resonance (MR) cholangiopancreatography in assessing the cause of pancreatitis in children.

Twenty healthy volunteers (aged 2-11 years) and 10 patients with acute pancreatitis (aged 3-12 years) who underwent MR cholangiopancreatography between December 1993 and February 1996 were studied retrospectively. The rate of visualization of the common bile duct and main pancreatic duct with MR cholangiopancreatography was assessed in the volunteer group. Depiction of pancreaticobiliary disease at MR cholangiopancreatography was assessed in the patient group.

MR cholangiopancreatography clearly showed the common bile duct in 20 of 20 volunteers (100%) and the main pancreatic duct in 13 of 20 volunteers (65%). MR cholangiopancreatography depicted a dilated common bile duct in six of 10 patients (60%) and an abnormal arrangement of the pancreaticobiliary duct in five of the six patients (83%) in whom this structural abnormality was proved at surgery. In the four patients without structural abnormality, MR cholangiopancreatography depicted a pseudocyst in one patient who had traumatic pancreatitis; the other three patients had normal findings. In one of these three patients, familial pancreatitis was considered to be the underlying disorder, and in the other two patients no cause was identified.

MR cholangiopancreatography may be helpful in diagnosing the cause of pancreatitis in children, especially in those with an abnormal pancreaticobiliary ductal junction.