Journal article
Pancreas Divisum in Pediatric Acute Recurrent and Chronic Pancreatitis: Report From INSPPIRE
Journal of clinical gastroenterology, Vol.53(6), pp.e232-e238
07/2019
DOI: 10.1097/MCG.0000000000001063
PMCID: PMC6275137
PMID: 29864067
Abstract
The significance of pancreas divisum (PD) as a risk factor for pancreatitis is controversial. We analyzed the characteristics of children with PD associated with acute recurrent or chronic pancreatitis to better understand its impact.
We compared children with or without PD in the well-phenotyped INSPPIRE (INternational Study group of Pediatric Pancreatitis: In search for a cuRE) cohort. Differences were analyzed using 2-sample t test or Wilcoxon rank sum test for continuous variables, Pearson χ or Fisher exact test for categorical variables.
PD was found in 52 of 359 (14.5%) subjects, a higher prevalence than the general population (∼7%). Females more commonly had PD (71% vs. 55%; P=0.02). Children with PD did not have a higher incidence of mutations in SPINK1, CFTR, CTRC compared with children with no PD. Children with PD were less likely to have PRSS1 mutations (10% vs. 34%; P<0.01) or a family history of pancreatitis (P<0.05), and more likely to have hypertriglyceridemia (11% vs. 3%; P=0.03). Children with PD underwent significantly more endoscopic procedures and pancreatic sphincterotomy. Patients with PD had fewer attacks of acute pancreatitis (P=0.03) and were less likely to develop exocrine pancreatic insufficiency (P=0.01). Therapeutic endoscopic retrograde cholangiopancreatography was considered most helpful if pancreatic duct was impacted with stones (83% helpful).
PD is likely a risk factor for acute recurrent pancreatitis and chronic pancreatitis in children that appears to act independently of genetic risk factors. Patients with PD and stones obstructing the pancreatic duct benefit most from therapeutic endoscopic retrograde cholangiopancreatography.
Details
- Title: Subtitle
- Pancreas Divisum in Pediatric Acute Recurrent and Chronic Pancreatitis: Report From INSPPIRE
- Creators
- Tom K Lin - Cincinnati Children's Hospital Medical Center, CincinnatiMaisam Abu-El-Haija - Cincinnati Children's Hospital Medical Center, CincinnatiJaimie D Nathan - Cincinnati Children's Hospital Medical Center, CincinnatiJoseph P Palermo - Cincinnati Children's Hospital Medical Center, CincinnatiBradley Barth - University of Texas Southwestern Medical School, DallasMelena Bellin - Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MNDouglas S Fishman - Department of Pediatrics, Baylor College of Medicine, Houston, TXSteven D Freedman - Harvard Medical SchoolCheryl E Gariepy - Nationwide Children's Hospital, Columbus, OHMatthew J Giefer - Seattle Children's Hospital, Seattle, WATanja Gonska - Hospital for Sick Children, Toronto, ONMelvin B Heyman - University of California San Francisco, San FranciscoRyan Himes - Department of Pediatrics, Baylor College of Medicine, Houston, TXSohail Z Husain - Children's Hospital of Pittsburgh, PittsburghQuin Liu - Cedars-Sinai Medical Center, Los Angeles, CAAsim Maqbool - Children's Hospital of Philadelphia, Philadelphia, PAMaria Mascarenhas - Children's Hospital of Philadelphia, Philadelphia, PABrian McFerron - Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, INVeronique D Morinville - Montreal Children's Hospital, McGill University, Montreal, QC, CanadaChee Y Ooi - School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, NSW, AustraliaEmily Perito - University of California San Francisco, San FranciscoJohn F Pohl - University of Utah, Salt Lake City, UTSue Rhee - University of California San Francisco, San FranciscoSarah Jane Schwarzenberg - Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MNUzma Shah - Massachusetts General Hospital for Children, Harvard Medical School, Boston, MADavid Troendle - University of Texas Southwestern Medical School, DallasSteven L Werlin - Medical College of Wisconsin, Milwaukee, WIMichael Wilschanski - Hadassah Hebrew University Hospital, Jerusalem, IsraelM Bridget Zimmerman - Department of BiostatisticsMark E Lowe - Washington University School of Medicine, St Louis, MOAliye Uc - Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- Journal of clinical gastroenterology, Vol.53(6), pp.e232-e238
- DOI
- 10.1097/MCG.0000000000001063
- PMID
- 29864067
- PMCID
- PMC6275137
- NLM abbreviation
- J Clin Gastroenterol
- ISSN
- 0192-0790
- eISSN
- 1539-2031
- Publisher
- United States
- Grant note
- U01 DK108326 / NIDDK NIH HHS P30 DK078392 / NIDDK NIH HHS U01 DK108334 / NIDDK NIH HHS R21 DK096327 / NIDDK NIH HHS R01 DK097820 / NIDDK NIH HHS UL1 TR002538 / NCATS NIH HHS UL1 TR000442 / NCATS NIH HHS P30 DK054759 / NIDDK NIH HHS
- Language
- English
- Date published
- 07/2019
- Academic Unit
- Stead Family Department of Pediatrics; Biostatistics; Radiation Oncology; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984047690602771
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