Acute and Chronic Pancreatitis

Pancreatitis is more prevalent in children than previously believed. The diagnosis of pancreatitis has increased over the past decade and large children’s hospitals treat 100 to 150 children a year for pancreatitis. Most patients have acute pancreatitis, and 10% or fewer have chronic pancreatitis. Greater physician awareness likely accounts for the increase in the diagnosis of acute pancreatitis in childhood. The etiologies of acute pancreatitis differ between children and adults, in whom gallstone- and alcohol-associated pancreatitis are predominant. In children, systemic illness, biliary disease, medications, and trauma encompass the majority of children with an identifiable etiology. A large portion of patients have no identifiable cause. Similarly, many patients have no identifiable cause for their chronic pancreatitis. Despite advances in understanding the pathophysiology of pancreatitis, care remains supportive. Fortunately, most children have a benign clinical course. Some develop complications, with fluid collections being the most common problem. A small group will have recurrent episodes of acute pancreatitis.

Definition and Classification

Over the years, the classification of inflammatory disorders of the pancreas has changed, but two broad categories have remained constant: acute and chronic.

Acute pancreatitis is a reversible process with no lasting effects on the pancreatic parenchyma or function.

Chronic pancreatitis is an irreversible process leading to changes in the parenchyma and function of the pancreas.