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Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

Hwang JY, Yoon HK, Kim KM - Pediatr Gastroenterol Hepatol Nutr (2015)

Bottom Line: Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children.Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology.This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

No MeSH data available.


Related in: MedlinePlus

A 7-year-old boy with hereditary pancreatitis (SPINK1 mutation) presented with chronic pancreatitis. (A) Computed tomography image showing multiple parenchymal calcifications, irregular dilatation of the pancreatic duct, and parenchymal atrophy. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography (MRCP) image showing diffuse dilatation of the pancreatic duct. The connection between the pseudocyst (asterisk) and pancreatic duct is shown (arrow). Note the minor duct crossing over the common bile duct (curved arrow) and pancreas divisum on the MRCP image. (C) Endoscopic retrograde cholangiopancretography confirming the connection between the pseudocyst and pancreatic duct. The contrasting agent filled the pseudocyst (open arrow). Note the irregular stricture of the pancreatic duct (arrow).
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Figure 3: A 7-year-old boy with hereditary pancreatitis (SPINK1 mutation) presented with chronic pancreatitis. (A) Computed tomography image showing multiple parenchymal calcifications, irregular dilatation of the pancreatic duct, and parenchymal atrophy. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography (MRCP) image showing diffuse dilatation of the pancreatic duct. The connection between the pseudocyst (asterisk) and pancreatic duct is shown (arrow). Note the minor duct crossing over the common bile duct (curved arrow) and pancreas divisum on the MRCP image. (C) Endoscopic retrograde cholangiopancretography confirming the connection between the pseudocyst and pancreatic duct. The contrasting agent filled the pseudocyst (open arrow). Note the irregular stricture of the pancreatic duct (arrow).

Mentions: Chronic pancreatitis is defined by irreversible architectural and functional changes in the pancreas due to long-standing pancreatic inflammation and injury [6]. It has been noted that chronic pediatric pancreatitis is mainly associated with obstructive and genetic causes [9]. MRCP can identify irregular ductal dilatation with or without stricture, calculi, and pseudocyst (Fig. 3 and 4). However, MRI has some limitations when identifying parenchymal calcifications and small pancreaticoliths or abnormalities in the small distal duct. Therefore, there have been attempts to combine MRI and unenhanced CT in order to diagnose chronic pancreatitis [10].


Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

Hwang JY, Yoon HK, Kim KM - Pediatr Gastroenterol Hepatol Nutr (2015)

A 7-year-old boy with hereditary pancreatitis (SPINK1 mutation) presented with chronic pancreatitis. (A) Computed tomography image showing multiple parenchymal calcifications, irregular dilatation of the pancreatic duct, and parenchymal atrophy. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography (MRCP) image showing diffuse dilatation of the pancreatic duct. The connection between the pseudocyst (asterisk) and pancreatic duct is shown (arrow). Note the minor duct crossing over the common bile duct (curved arrow) and pancreas divisum on the MRCP image. (C) Endoscopic retrograde cholangiopancretography confirming the connection between the pseudocyst and pancreatic duct. The contrasting agent filled the pseudocyst (open arrow). Note the irregular stricture of the pancreatic duct (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493250&req=5

Figure 3: A 7-year-old boy with hereditary pancreatitis (SPINK1 mutation) presented with chronic pancreatitis. (A) Computed tomography image showing multiple parenchymal calcifications, irregular dilatation of the pancreatic duct, and parenchymal atrophy. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography (MRCP) image showing diffuse dilatation of the pancreatic duct. The connection between the pseudocyst (asterisk) and pancreatic duct is shown (arrow). Note the minor duct crossing over the common bile duct (curved arrow) and pancreas divisum on the MRCP image. (C) Endoscopic retrograde cholangiopancretography confirming the connection between the pseudocyst and pancreatic duct. The contrasting agent filled the pseudocyst (open arrow). Note the irregular stricture of the pancreatic duct (arrow).
Mentions: Chronic pancreatitis is defined by irreversible architectural and functional changes in the pancreas due to long-standing pancreatic inflammation and injury [6]. It has been noted that chronic pediatric pancreatitis is mainly associated with obstructive and genetic causes [9]. MRCP can identify irregular ductal dilatation with or without stricture, calculi, and pseudocyst (Fig. 3 and 4). However, MRI has some limitations when identifying parenchymal calcifications and small pancreaticoliths or abnormalities in the small distal duct. Therefore, there have been attempts to combine MRI and unenhanced CT in order to diagnose chronic pancreatitis [10].

Bottom Line: Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children.Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology.This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

No MeSH data available.


Related in: MedlinePlus