title: Acute pancreatitis associated with biliary disease in children.
abstract: OBJECTIVE
  Biliary disease is one of the most common causes of acute pancreatitis in adults; however, this cause and outcome in children have rarely been described in the literature. Therefore, the present study was conducted to evaluate the role of biliary disease as a cause of acute pancreatitis in children.
  
  
  METHODS
  The present study included 56 children with acute pancreatitis, of which 16 (29%) cases were associated with biliary disease. The 16 cases consisted of four boys and 12 girls ranging in age from 2 to 13 years. The underlying causes of the biliary disease were evaluated, as well as its clinical presentations, management modalities, and outcomes.
  
  
  RESULTS
  The causes of biliary disease in the 16 children included choledochal cyst in seven, biliary sludge in six, gallstone in two, and anomalous pancreaticobiliary junction in one. Acute pancreatitis with biliary disease showed increased presentation of jaundice and abnormalities in a liver-function test. Therapeutic interventions were performed more frequently in acute pancreatitis associated with biliary disease. All seven children with choledochal cysts needed hepaticojejunostomy. Of eight children with biliary sludge or gallstones, five children remained free of and two suffered from repeated attacks of pancreatitis after endoscopic papillotomy. Mortality did not occur.
  
  
  CONCLUSIONS
  The present study suggests that biliary disease can be one of the causes of acute pancreatitis in children and has the clinical characteristics of jaundice and/or abnormalities in a liver-function test. Appropriate therapeutic interventions should be considered as the treatment modality.
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Bo Hwa
authors.initials: BH
authors.lastname: Choi
authors.forename: Yean Jung
authors.initials: YJ
authors.lastname: Lim
authors.forename: Chong Hyun
authors.initials: CH
authors.lastname: Yoon
authors.forename: Ellen Ai-Ran
authors.initials: EA
authors.lastname: Kim
authors.forename: Young Seo
authors.initials: YS
authors.lastname: Park
authors.forename: Kyung Mo
authors.initials: KM
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001660:Biliary Tract Diseases / Q000150:complications* / Q000209:etiology / Q000628:therapy; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008111:Liver Function Tests; D008297:Male; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy