Classification of Acute Pancreatitis in the Pediatric Population: Clinical Report From the NASPGHAN Pancreas Committee.
Acute pancreatitis (AP) is an emerging problem in pediatrics, with most cases resolving spontaneously. Approximately 10% to 30%, however, are believed to develop "severe acute pancreatitis" (SAP).



This consensus statement on the classification of AP in pediatrics was developed through a working group that performed an evidence-based search for classification of AP in adult pancreatitis, definitions and criteria of systemic inflammatory response syndrome, and organ failure in pediatrics.



Severity in pediatric AP is classified as mild, moderately severe, or severe. Mild AP is defined by AP without organ failure, local or systemic complications, and usually resolves in the first week. Moderately SAP is defined by the presence of transient organ failure that resolves in no >48 hours, or local complications or exacerbation of co-morbid disease. SAP is defined by persistent organ failure that lasts <48 hours. The presence of systemic inflammatory response syndrome is associated with increased risk for persistent organ dysfunction. Criteria to define organ failure must be pediatric- and age-based.



Classifying AP in pediatrics in a uniform fashion will help define outcomes and encourage the development of future studies in the field of pediatric pancreatitis.
*Division of Gastroenterology Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH †Division of Pediatric Gastroenterology, Hepatology and Nutrition, Rady Children's Hospital, San Diego, CA ‡Division of Pediatric Gastroenterology and Nutrition, Children's Hospital of Richmond at VCU, Virginia Commonwealth University School of Medicine, Richmond, VA §Medical College of Wisconsin, Milwaukee, WI ||Division of Gastroenterology, Hepatology and Nutrition, Ohio State University, Columbus, OH ¶Division of Gastroenterolology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA #Division of Pediatric Gastroenterology and Nutrition, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Maisam
M
Abu-El-Haija
Soma
S
Kumar
Flora
F
Szabo
Steven
S
Werlin
Darwin
D
Conwell
Peter
P
Banks
Veronique D
VD
Morinville
D000208:Acute Disease; D002648:Child; D006801:Humans; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000209:etiology; D010195:Pancreatitis / Q000145:classification* / Q000150:complications / Q000175:diagnosis*; D010372:Pediatrics; D012720:Severity of Illness Index; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000209:etiology