The Cribsiders

S6 Ep139: Behind the Bellyache: Acute Pancreatitis

Apr 23, 2025
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ADVICE

Pediatric Acute Pancreatitis Diagnosis

  • Diagnose acute pancreatitis in children when two of three criteria are met: pancreatic-origin abdominal pain, amylase or lipase over 3x normal, or imaging showing pancreatitis.
  • Carefully interpret enzyme levels as upper limits of normal vary between labs.
ADVICE

Essential Labs for Pancreatitis Workup

  • For suspected pancreatitis with possible gallstones, order CBC with differential, liver enzymes, total and direct bilirubin, amylase, and lipase.
  • These labs help confirm diagnosis and assess for biliary obstruction or infection.
ADVICE

Ultrasound First for Imaging

  • Start imaging with transabdominal ultrasound for pediatric acute pancreatitis or biliary disease suspicion.
  • Ultrasound is non-invasive, sedation-free, and identifies pancreatic inflammation and biliary sludge or stones in many cases.
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