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The latest issue of the British Medical Journal (BMJ) Pediatrics has published this article, summarizing the review on pediatric pancreatitis, with concise points and strong clinical practicality, worthy of learning and reference. The full translation is as follows (original text attached at the end):
Pancreatitis is a disease characterized by inflammation of the pancreas, with multiple etiologies. Improving clinical proficiency in the timely diagnosis and effective treatment of acute pancreatitis, acute recurrent pancreatitis, and chronic pancreatitis can improve the prognosis for pediatric patients.
We have established consensus guidelines for pediatric pancreatitis through the British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) Pancreatitis Working Group, ensuring that clinicians pay close attention to these children. These patients typically receive medical care within a multidisciplinary framework, facilitating future research in this field.
The initial assessment of children with pancreatitis should include: serum amylase/lipase, triglycerides, full blood count, C-reactive protein, renal function, liver function, blood glucose, blood calcium, and blood gas analysis. A rapid transabdominal ultrasound is recommended for all suspected cases of pancreatitis to identify changes in pancreatic parenchyma and the biliary duct, as well as other complications.
For fluid resuscitation in children with pancreatitis, crystalloids or Ringer’s lactate should be used, with an initial intravenous bolus of 10-20 mL/kg, followed by 1.5-2 times the maintenance volume. Urine output should be monitored hourly during the initial 24-48 hours. Oral intake may be initiated within the first 24 hours after the start of fluid resuscitation, and fat intake should not be restricted.
For children with suspected autoimmune pancreatitis, the examination should include immunoglobulin levels (IgG, IgM, IgA, IgG subclasses), complement components, and autoantibodies to confirm the diagnosis.
Significant interventional treatments for pancreatitis and related complications can be performed via endoscopic retrograde cholangiopancreatography or endoscopic ultrasound.
For children with pancreatitis, referral to a specialized pediatric hepatobiliary surgical team is strongly recommended. Close collaboration with a pediatric hepatobiliary surgical expert center can improve diagnostic and management outcomes for these patients.
Pancreatitis in children: practical management from the BSPGHAN Pancreatitis Working Group
http://orcid.org/0000-0002-1934-5370 Vangelis J Giamouris1, Mark Davenport2, Ieuan Havard Davies3, Gillian Geaney1, Tushar Banerjee4, Christopher Bakewell5, Paul Henderson6, http://orcid.org/0000-0002-0174-4787 Tassos Grammatikopoulos1,7 Correspondence to Dr. Vangelis J Giamouris; [email protected]
Abstract
Pancreatitis, a condition characterised by inflammation of the pancreas, has multiple aetiologies. Improving clinical proficiency in prompt diagnosis and effective management leads to better outcomes for children with acute pancreatitis, acute recurrent pancreatitis, and chronic pancreatitis. Establishing consensus guidance via the British Society of Paediatric Gastroenterology Hepatology and Nutrition (BSPGHAN) Pancreatitis Working Group has ensured further focus on these patients who are often cared for in a multidisciplinary framework and may prompt future research in this area. Initial assessment includes serum amylase/lipase, triglyceride levels, full blood count, C reactive protein, renal and liver function profile, glucose, calcium and capillary blood gas. Fasted transabdominal ultrasound for all children and young people with suspected pancreatitis is recommended to identify pancreatic parenchyma and pancreatobiliary ductal changes, and complications. For fluid resuscitation, use crystalloids or Ringer’s lactate: initial bolus of 10 to 20 mL/kg, 1.5–2 times maintenance volume, with hourly monitoring of urine output over the initial 24–48 hours. Initiate oral intake within the first 24 hours after fluid resuscitation; fat restriction is not recommended. For suspected autoimmune pancreatitis, workup includes immunoglobulin levels (IgG, IgM, IgA, IgG subclasses), complement components and autoantibody profile to confirm diagnosis. Significant interventional management for pancreatitis and related complications is performed via endoscopic retrograde cholangiopancreatography or endoscopic ultrasound; referral to a specialised paediatric hepatobiliary surgical team is highly recommended. Close collaboration with a specialist centre can improve diagnostic and management pathways and outcomes for children.