Causes of chronic pancreatitis in children and adolescents
- Mohamad Miqdady, MD
Mohamad Miqdady, MD
- Adjunct Faculty
- Cleveland Clinic Foundation
- Seiji Kitagawa, MD
Seiji Kitagawa, MD
- Associate Professor of Pediatric Gastroenterology
- Baylor College of Medicine
- Section Editors
- William J Klish, MD
William J Klish, MD
- Section Editor — Pediatric Gastroenterology
- Emeritus Professor of Pediatrics
- Baylor College of Medicine
- David C Whitcomb, MD, PhD
David C Whitcomb, MD, PhD
- Section Editor — Pancreatic Diseases
- Professor of Medicine
- University of Pittsburgh School of Medicine
Chronic pancreatitis is a progressive inflammatory disease of the pancreas. It is characterized by structural changes that result in irreversible exocrine and/or endocrine pancreatic insufficiency [1-3]. The structural changes include diffuse or focal destruction, sclerosis, acinar cell loss, islet cell loss, inflammatory cell infiltrate, and pancreatic duct abnormalities. Intraductal obstruction may be caused by protein-plugs and/or calculi.
Because the pancreas has a large reserve capacity, symptoms of pancreatic failure do not develop until there is loss of over 90 percent of pancreatic exocrine function . Most patients with chronic pancreatitis initially experience recurrent abdominal pain, which may progress to persistent pain. Less commonly, patients are asymptomatic or have minimal symptoms until developing signs of advanced disease, such as diabetes mellitus or fat and protein malabsorption. With advances in diagnostic methods, the diagnosis of chronic pancreatitis is becoming more common in children. (See "Clinical manifestations and diagnosis of chronic pancreatitis in children".)
A variety of pathologic processes can cause chronic pancreatitis in children. However, no specific etiology can be identified for many cases, termed "idiopathic chronic pancreatitis." Hereditary pancreatitis is a form of chronic pancreatitis that often presents during childhood and adolescence; it will be discussed briefly here and in detail in a separate topic review. (See "Hereditary pancreatitis".)
The following issues are discussed in separate topic reviews:
●The clinical manifestations and diagnosis of chronic pancreatitis in children. (See "Clinical manifestations and diagnosis of chronic pancreatitis in children".)
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