title: Risk factors associated with biliary pancreatitis in children.
abstract: OBJECTIVE
  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.
authors: Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.
authors: Michael H
authors: MH
authors: Ma
authors: Harrison X
authors: HX
authors: Bai
authors: Alexander J
authors: AJ
authors: Park
authors: Sahibzada U
authors: SU
authors: Latif
authors: Pramod K
authors: PK
authors: Mistry
authors: Dinesh
authors: D
authors: Pashankar
authors: Veronika S
authors: VS
authors: Northrup
authors: Vineet
authors: V
authors: Bhandari
authors: Sohail Z
authors: SZ
authors: Husain
mesh_terms: D000293:Adolescent; D000681:Amylases / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001660:Biliary Tract Diseases / Q000150:complications / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D044383:Black People; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D042882:Gallstones / Q000150:complications / Q000473:pathology; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008049:Lipase / Q000097:blood; D016015:Logistic Models; D010195:Pancreatitis / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D012307:Risk Factors; D044465:White People; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D008049:Lipase; D000681:Amylases