Acute pancreatitis associated with biliary disease in children.
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.
Choi
Bo Hwa
BH
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Lim
Yean Jung
YJ
Yoon
Chong Hyun
CH
Kim
Ellen Ai-Ran
EA
Park
Young Seo
YS
Kim
Kyung Mo
KM
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