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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

An 11-year-old male diagnosed with acute lymphoblastic leukemia who was treated using L-asparaginase. (A) Contrast-enhanced computed tomography scan showing acute necrotic collections (arrows). The area of high attenuation (asterisk) may indicate hemorrhage. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography image obtained 2 months later showing walled-off necrosis at the neck and tail of the pancreas (arrows). Dark signal intensities (curved arrow) may indicate hemosiderin deposits.
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Figure 7: An 11-year-old male diagnosed with acute lymphoblastic leukemia who was treated using L-asparaginase. (A) Contrast-enhanced computed tomography scan showing acute necrotic collections (arrows). The area of high attenuation (asterisk) may indicate hemorrhage. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography image obtained 2 months later showing walled-off necrosis at the neck and tail of the pancreas (arrows). Dark signal intensities (curved arrow) may indicate hemosiderin deposits.

Mentions: Drug-induced pancreatitis accounts for up to 12% of cases of acute pediatric pancreatitis [13], but only 0.1-2% of adult cases [19]. Drug-induced pancreatitis is particularly important in children with acute lymphoblastic leukemia (ALL) receiving L-asparaginase therapy, because acute pancreatitis can result. A recent study reported that the high mortality of ALL patients is due to coexisting acute pancreatitis [20]. Cytosine arabinoside treatment, hypercalcemia, and hypertriglyceridemia can also be associated with pancreatitis in ALL patients. Drug-induced pancreatitis also demonstrates a wide spectrum of disease manifestations, from subclinical pancreatitis to fatal hemorrhagic pancreatitis (Fig. 7).


Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

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

An 11-year-old male diagnosed with acute lymphoblastic leukemia who was treated using L-asparaginase. (A) Contrast-enhanced computed tomography scan showing acute necrotic collections (arrows). The area of high attenuation (asterisk) may indicate hemorrhage. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography image obtained 2 months later showing walled-off necrosis at the neck and tail of the pancreas (arrows). Dark signal intensities (curved arrow) may indicate hemosiderin deposits.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: An 11-year-old male diagnosed with acute lymphoblastic leukemia who was treated using L-asparaginase. (A) Contrast-enhanced computed tomography scan showing acute necrotic collections (arrows). The area of high attenuation (asterisk) may indicate hemorrhage. (B) Maximum intensity projection 3-dimensional magnetic resonance cholangiopancreatography image obtained 2 months later showing walled-off necrosis at the neck and tail of the pancreas (arrows). Dark signal intensities (curved arrow) may indicate hemosiderin deposits.
Mentions: Drug-induced pancreatitis accounts for up to 12% of cases of acute pediatric pancreatitis [13], but only 0.1-2% of adult cases [19]. Drug-induced pancreatitis is particularly important in children with acute lymphoblastic leukemia (ALL) receiving L-asparaginase therapy, because acute pancreatitis can result. A recent study reported that the high mortality of ALL patients is due to coexisting acute pancreatitis [20]. Cytosine arabinoside treatment, hypercalcemia, and hypertriglyceridemia can also be associated with pancreatitis in ALL patients. Drug-induced pancreatitis also demonstrates a wide spectrum of disease manifestations, from subclinical pancreatitis to fatal hemorrhagic pancreatitis (Fig. 7).

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