Risk Factors Associated With Biliary Pancreatitis in Children
- 1 May 2012
- journal article
- research article
- Published by Wiley in Journal of Pediatric Gastroenterology and Nutrition
- Vol. 54 (5), 651-656
- https://doi.org/10.1097/mpg.0b013e31823a897d
Abstract
Objectives: Little is known about risk factors for biliary pancreatitis in children. We characterized cases of pediatric biliary pancreatitis, compared biliary with nonbiliary cases, examined differences in presentation between younger and older children, and studied features distinguishing gallstone- from sludge-induced pancreatitis. Methods: We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to a tertiary care hospital from 1994 to 2007. Results: Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had 2.85 (P = 0.01) and 5.59 (P = 0.003) times higher probability for biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared with other causes (P < 0.05). In multiple logistic regression, aspartate aminotransferase was an independent predictor of biliary pancreatitis (odds ratio 6.69, P = 0.001). When comparing gallstone- with sludge-induced causes, obesity was an independent predictor (38% more prevalent, P < 0.01) of gallstone cases. Conclusions: Hispanic ethnicity is a risk factor and aspartate aminotransferase is a biomarker for biliary pancreatitis over other causes. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis.This publication has 33 references indexed in Scilit:
- What Have We Learned About Acute Pancreatitis in Children?Journal of Pediatric Gastroenterology and Nutrition, 2011
- A Comparison of Presentation and Management Trends in Acute Pancreatitis Between Infants/Toddlers and Older ChildrenJournal of Pediatric Gastroenterology and Nutrition, 2010
- Increasing Incidence of Acute Pancreatitis at an American Pediatric Tertiary Care CenterPancreas, 2010
- Changing Referral Trends of Acute Pancreatitis in Children: A 12‐year Single‐center AnalysisJournal of Pediatric Gastroenterology and Nutrition, 2009
- Prospective trial comparing solid-state catheter and water-perfusion triple-lumen catheter for sphincter of Oddi manometry done at the time of ERCPGastrointestinal Endoscopy, 2009
- Experimental evidence of obesity as a risk factor for severeacute pancreatitisWorld Journal of Gastroenterology, 2009
- Changing incidence of acute pancreatitis: 10‐year experience at the Royal Children's Hospital, MelbourneJournal of Gastroenterology and Hepatology, 2007
- Microlithiasis and sludgeBest Practice & Research Clinical Gastroenterology, 2006
- ObesityPancreas, 1999
- Biochemical Identification of Patients with Gallstones Associated with Acute Pancreatitis on the Day of Admission to HospitalAnnals of Surgery, 1985