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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 4-year-old male with a history of blunt abdominal trauma. (A) Reformatted coronal contrast-enhanced computed tomography scan showing fracture at the pancreas neck (arrow) and peripancreatic fluid collection (arrowheads). (B) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography images obtained 17 days after injury, showing a pseudocyst (asterisk) connected to the collected fluid at the fracture site (curved arrow).
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Figure 6: A 4-year-old male with a history of blunt abdominal trauma. (A) Reformatted coronal contrast-enhanced computed tomography scan showing fracture at the pancreas neck (arrow) and peripancreatic fluid collection (arrowheads). (B) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography images obtained 17 days after injury, showing a pseudocyst (asterisk) connected to the collected fluid at the fracture site (curved arrow).

Mentions: Blunt trauma is one of the most common causes of pancreatic injury in children, resulting in >50% of pediatric cases [17]. The body of the pancreas is the most vulnerable site of blunt injury because it can be easily crushed against the vertebral column (Fig. 6A) [1718]. In an acute clinical setting, CT can be modality of choice regarding fast imaging time and accuracy for abdominal traumatic injury. MRI with MRCP is performed when the ductal injury is suspected although CT is the best modality for traumatic pancreatitis in acute clinical setting. Pseudocyst formation is common and has been reported in >50% of patients with traumatic pancreatitis. Approximately 60% of pancreatic pseudocysts are due to blunt trauma [17]. MRI and MRCP can reveal parenchymal changes, including pancreatic fracture, laceration, hemorrhage, pancreatic contusion, peripancreatic fluid collection, hematoma, pseudocyst formation, and other associated injuries in the adjacent abdominal organs (Fig. 6B) [18].


Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

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

A 4-year-old male with a history of blunt abdominal trauma. (A) Reformatted coronal contrast-enhanced computed tomography scan showing fracture at the pancreas neck (arrow) and peripancreatic fluid collection (arrowheads). (B) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography images obtained 17 days after injury, showing a pseudocyst (asterisk) connected to the collected fluid at the fracture site (curved arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: A 4-year-old male with a history of blunt abdominal trauma. (A) Reformatted coronal contrast-enhanced computed tomography scan showing fracture at the pancreas neck (arrow) and peripancreatic fluid collection (arrowheads). (B) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography images obtained 17 days after injury, showing a pseudocyst (asterisk) connected to the collected fluid at the fracture site (curved arrow).
Mentions: Blunt trauma is one of the most common causes of pancreatic injury in children, resulting in >50% of pediatric cases [17]. The body of the pancreas is the most vulnerable site of blunt injury because it can be easily crushed against the vertebral column (Fig. 6A) [1718]. In an acute clinical setting, CT can be modality of choice regarding fast imaging time and accuracy for abdominal traumatic injury. MRI with MRCP is performed when the ductal injury is suspected although CT is the best modality for traumatic pancreatitis in acute clinical setting. Pseudocyst formation is common and has been reported in >50% of patients with traumatic pancreatitis. Approximately 60% of pancreatic pseudocysts are due to blunt trauma [17]. MRI and MRCP can reveal parenchymal changes, including pancreatic fracture, laceration, hemorrhage, pancreatic contusion, peripancreatic fluid collection, hematoma, pseudocyst formation, and other associated injuries in the adjacent abdominal organs (Fig. 6B) [18].

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