Novel Approaches to the Diagnosis of Pancreatic Disease in Childhood

The diagnosis of pancreatic disease is difficult. Most tests of pancreatic function need to be interpreted in the context of the patient's presenting history and clinical examination. In childhood, classical signs of hemorrhagic pancreatitis are seldom useful because they rarely occur. A careful history is particularly useful in conditions with an autosomal dominant inheritance such as hereditary pancreatitis. Pedigree construction should be undertaken in all cases of pancreatitis. Assessment of exocrine pancreatic function is made easier by a thorough appreciation of the constellation of signs, both pancreatic and extrapancreatic, of various pancreatic disease. The purpose of this review is to explore novel means of diagnosing pancreatic disease, including pancreatic function testing, organ imaging and, more recently, molecular biology techniques. Most of the potentially novel techniques surround organ imaging or molecular biology.