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Pediatric Critical Care Medicine pp 29–37Cite as

Acute Pancreatitis

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Abstract

Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems. Clinically, two forms of acute pancreatitis are recognized: the mild form associated with minimal organ dysfunction and uneventful recovery, and the severe form associated with organ failure and/or local complications such as necrosis, walled-off pancreatic necrosis and pseudocysts. Due to the rareness and heterogeneous symptoms of acute pancreatitis in children, the disease is often misdiagnosed. Acute pancreatitis in children is often found after abdominal trauma, biliary or pancreatic malformation, drugs, biliary stones, viral or bacterial infections, systemic illnesses and metabolic diseases. In more than 20 % of cases, no clear etiological factors can be detected; thus, many young patients have an idiopathic form of pancreatitis. The percentage of severe pancreatitis in children is about 15 %; death occurs in about 5 % of cases. Improvements in diagnostic and imaging methods and growing awareness cannot account for the recent increases observed in the incidence of pediatric acute pancreatitis. Regarding treatment, the pain must be alleviated, and fluids and electrolytes should be administered immediately. After the acute pancreatitis is resolved, genetic tests should be carried out in cases of patients having a disease of unknown origin.

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Abbreviations

BUN:

Blood urea nitrogen

CFTR-gene:

Cystic fibrosis transmembrane conductance regulator gene

CRP:

C-reactive protein

CT:

Computed tomography

ERCP:

Endoscopic retrograde cholangiopancreatography

IL-1:

Interleukin 1

IL-10:

Interleukin 10

IL-6:

Interleukin-6

IL-8:

Interleukuin-8

LDH:

Lactate dehydrogenase

MR:

Magnetic resonance

PRSS-1:

Protease-serine gene-1

PSTI:

Pancreatic secretory trypsin inhibitor

SPINK1:

Serine proteases inhibitor–Kazal type 1

TAP:

Trypsinogen activation peptide

TNF-alfa:

Tumor necrosis factor-alfa

TPN:

Total parenteral nutrition

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Authors and Affiliations

  1. Department of Digestive Diseases and Internal Medicine, Sant’Orsola-Malpighi, Via Massarenti 9, Bologna, 40138, Italy

    Raffaele Pezzilli MD

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  1. Raffaele Pezzilli MD
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Correspondence to Raffaele Pezzilli MD .

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Editors and Affiliations

  1. Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Derek S. Wheeler

  2. Div. of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA

    Hector R. Wong

  3. MICHR, University of Michigan Medical Scho, Ann Arbor, Michigan, USA

    Thomas P. Shanley

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Pezzilli, R. (2014). Acute Pancreatitis. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6416-6_3

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  • DOI: https://doi.org/10.1007/978-1-4471-6416-6_3

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