Open AccessRisk Factors Associated With Biliary Pancreatitis in Children
Author(s) -
Ma Michael H.,
Bai Harrison X.,
Park Alexander J.,
Latif Sahibzada U.,
Mistry Pramod K.,
Pashankar Dinesh,
Northrup Veronika S.,
Bhandari Vineet,
Husain Sohail Z.
Publication year - 2012
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e31823a897d
Subject(s) - medicine , pancreatitis , gallstones , gastroenterology , odds ratio , risk factor , prospective cohort study
Objectives: 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.