Gallstone Pancreatitis in Pediatric Patients--a Common Disease in an Uncommon Population (Scientific Article) (Clinical Report‪)‬

Introduction Pediatric pancreatitis remains uncommon in comparison to the adult population. In the United States, 50-60% of adult acute pancreatitis cases in community hospitals are related to cholelithiasis. (1) Pancreatitis in children, however, is most commonly related to trauma, infection, systemic disease, drug reaction, and anatomic abnormalities of the pancreatobiliary tree. (2,3,4) Gallstone pancreatitis is an even more unusual finding occurring in only 5% of children undergoing cholecystectomy. (2) Teenage girls compromise the largest group of children with cholelithiasis, with a sharp increase seen after puberty due to the lithogenic effect of estrogen on bile. (5) Initial presentation may include abdominal pain, emesis, and jaundice; and may be associated with chronic infections, hemolytic disorders, total parenteral nutrition, furosemide administration, and previous ileal resection. (2,6) It was previously believed that actual obstruction of the pancreatic duct led to pancreatitis; however, patients presenting with pancreatitis and cholelithiasis, in the absence of choledocholithiasis, have led to the theory that the inflammatory reaction created at the ampulla by the passage of gallbladder stones may additionally induce pancreatitis.