Abstract
Background: There are unexpectedly large differences between the incidences of acute pancreatitis (AP) as indicated by different hospitals. Retrospective studies suggest that the reason behind this is the large differences that exist between the local managements of abdominal pain at emergency units. Unfortunately, no evidence-based medicine (EBM) guidelines are available to give proper instruction concerning the necessity of serum pancreatic enzyme measurement during abdominal pain. Summary: Pain in Early Phase of Pediatric Pancreatitis (PINEAPPLE) is an observational, multinational observational clinical trial to explore the route from the first sign of abdominal pain to the diagnosis of pancreatitis (PINEAPPLE trial). The PINEAPPLE-R subtrial is a retrospective review on the records of children (patients under 18) appearing at emergency units - a review of their clinical symptoms, results of imaging examinations and laboratory parameters. The PINEAPPLE-P subtrial is a prospective trial designed to develop a fast and simple EBM guideline that helps to evaluate (in a reliable and cost-efficient way) the necessity of pancreatic enzyme test and abdominal ultrasonography (or even computed tomography) when a child has abdominal pain. The trial has been registered at the ISRCTN registry and has received the relevant ethical approval. Key Message: The PINEAPPLE trial will help to recognize AP in children in a highly efficient manner.
Journal Section:
Original Paper
References
1.
Satoh K, Shimosegawa T, Masamune A, Hirota M, Kikuta K, Kihara Y, Kuriyama S, Tsuji I, Satoh A, Hamada S; Research Committee of Intractable Diseases of the Pancreas: Nationwide epidemiological survey of acute pancreatitis in Japan. Pancreas 2011;40:503-507.
[PubMed]
2.
Yadav D, Lowenfels AB: Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas 2006;33:323-330.
[PubMed]
3.
Joergensen M, Brusgaard K, Crüger DG, Gerdes AM, de Muckadell OB: Incidence, prevalence, etiology, and prognosis of first-time chronic pancreatitis in young patients: a nationwide cohort study. Dig Dis Sci 2010;55:2988-2998.
[PubMed]
4.
Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, Gangarosa LM, Thiny MT, Stizenberg K, Morgan DR, Ringel Y, Kim HP, Dibonaventura MD, Carroll CF, Allen JK, Cook SF, Sandler RS, Kappelman MD, Shaheen NJ: Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 2012;143:1179-1187.
[PubMed]
5.
Bai HX, Lowe ME, Husain SZ: What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr 2011;52:262-270.
[PubMed]
6.
Park A, Latif SU, Shah AU, Tian J, Werlin S, Hsiao A, Pashankar D, Bhandari V, Nagar A, Husain SZ: Changing referral trends of acute pancreatitis in children: a 12-year single-center analysis. J Pediatr Gastroenterol Nutr 2009;49:316-322.
[PubMed]
7.
Morinville VD, Barmada MM, Lowe ME: Increasing incidence of acute pancreatitis at an American pediatric tertiary care center: is greater awareness among physicians responsible? Pancreas 2010;39:5-8.
[PubMed]
8.
Nydegger A, Heine RG, Ranuh R, Gegati-Levy R, Crameri J, Oliver MR: Changing incidence of acute pancreatitis: 10-year experience at the royal children's hospital, Melbourne. J Gastroenterol Hepatol 2007;22:1313-1316.
[PubMed]
9.
Morinville VD, Husain SZ, Bai H, Barth B, Alhosh R, Durie PR, Freedman SD, Himes R, Lowe ME, Pohl J, Werlin S, Wilschanski M, Uc A; INSPPIRE Group: Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr 2012;55:261-265.
[PubMed]
10.
Dhroove G, Chogle A, Saps M: A million-dollar work-up for abdominal pain: is it worth it? J Pediatr Gastroenterol Nutr 2010;51:579-583.
[PubMed]
11.
Hritz I, Czakó L, Dubravcsik Z, Farkas G, Kelemen D, Lásztity N, Morvay Z, Oláh A, Pap Á, Párniczky A, Sahin-Tóth M, Szentkereszti Z, Szmola R, Szücs Á, Takács T, Tiszlavicz L, Hegyi P; Magyar Hasnyálmirigy Munkacsoport, Hungarian Pancreatic Study Group: [Acute pancreatitis. Evidence-based practice guidelines, prepared by the Hungarian Pancreatic Study Group]. Orv Hetil 2015;156:244-261.
[PubMed]
12.
Takács T, Czakó L, Dubravcsik Z, Farkas G, Hegyi P, Hritz I, Kelemen D, Lásztity N, Morvay Z, Oláh A, Pap Á, Párniczky A, Patai Á, Sahin-Tóth M, Szentkereszti Z, Szmola R, Tiszlavicz L, Szücs Á; Magyar Hasnyálmirigy Munkacsoport: [Chronic pancreatitis. Evidence based management guidelines of the Hungarian Pancreatic Study Group]. Orv Hetil 2015;156:262-288.
[PubMed]
13.
Párniczky A, Czakó L, Dubravcsik Z, Farkas G, Hegyi P, Hritz I, Kelemen D, Morvay Z, Oláh A, Pap Á, Sahin-Tóth M, Szabó F, Szentkereszti Z, Szmola R, Takács T, Tiszlavicz L, Veres G, Szücs Á, Lásztity N; Magyar Hasnyálmirigy Munkacsoport Hungarian Pancreatic Study Group: [Pediatric pancreatitis. Evidence based management guidelines of the Hungarian Pancreatic Study Group]. Orv Hetil 2015;156:308-325.
[PubMed]
14.
Dubravcsik Z, Farkas G, Hegyi P, Hritz I, Kelemen D, Lásztity N, Morvay Z, Oláh A, Pap Á, Párniczky A, Sahin-Tóth M, Szentkereszti Z, Szmola R, Takács T, Tiszlavicz L, Szücs Á, Czakó L; Magyar Hasnyálmirigy Munkacsoport Hungarian Pancreatic Study Group: [Autoimmune pancreatitis. Evidence based management guidelines of the Hungarian Pancreatic Study Group]. Orv Hetil 2015;156:292-307.
[PubMed]
15.
Szmola R, Farkas G, Hegyi P, Czakó L, Dubravcsik Z, Hritz I, Kelemen D, Lásztity N, Morvay Z, Oláh A, Párniczky A, Rubovszky G, Sahin-Tóth M, Szentkereszti Z, Szücs Á, Takács T, Tiszlavicz L, Pap Á; Magyar Hasnyálmirigy Munkacsoport Hungarian Pancreatic Study Group: [Pancreatic cancer. Evidence based management guidelines of the Hungarian Pancreatic Study Group]. Orv Hetil 2015;156:326-339.
[PubMed]
16.
Hritz I, Hegyi P: Early achievable severity (EASY) index for simple and accurate expedite risk stratification in acute pancreatitis. J Gastrointestin Liver Dis 2015;24:177-182.
[PubMed]
17.
Dubravcsik Z, Madácsy L, Gyökeres T, Vincze Á, Szepes Z, Hegyi P, Hritz I, Szepes A; Hungarian Pancreatic Study Group: Preventive pancreatic stents in the management of acute biliary pancreatitis (PREPAST trial): pre-study protocol for a multicenter, prospective, randomized, interventional, controlled trial. Pancreatology 2015;15:115-123.
[PubMed]
18.
Berney T, Belli D, Bugmann P, Beghetti M, Morel P, LeCoultre C: Influence of severe underlying pathology and hypovolemic shock on the development of acute pancreatitis in children. J Pediatr Surg 1996;31:1256-1261.
[PubMed]
19.
Yeung CY, Lee HC, Huang FY, Ho MY, Kao HA, Liang DC, Hsu CH, Hung HY, Chang PY, Sheu JC: Pancreatitis in children - experience with 43 cases. Eur J Pediatr 1996;155:458-463.
[PubMed]
20.
Haddock G, Coupar G, Youngson GG, MacKinlay GA, Raine PA: Acute pancreatitis in children: a 15-year review. J Pediatr Surg 1994;29:719-722.
[PubMed]
21.
Weizman Z, Durie PR: Acute pancreatitis in childhood. J Pediatr 1988;113(1 pt 1):24-29.
[PubMed]
22.
Ziegler DW, Long JA, Philippart AI, Klein MD: Pancreatitis in childhood. Experience with 49 patients. Ann Surg 1988;207:257-261.
[PubMed]
23.
Jordan SC, Ament ME: Pancreatitis in children and adolescents. J Pediatr 1977;91:211-216.
[PubMed]
24.
Werlin SL, Kugathasan S, Frautschy BC: Pancreatitis in children. J Pediatr Gastroenterol Nutr 2003;37:591-595.
[PubMed]
25.
Park AJ, Latif SU, Ahmad MU, Bultron G, Orabi AI, Bhandari V, Husain SZ: A comparison of presentation and management trends in acute pancreatitis between infants/toddlers and older children. J Pediatr Gastroenterol Nutr 2010;51:167-170.
[PubMed]
26.
Tiao MM, Chuang JH, Ko SF, Kuo HW, Liang CD, Chen CL: Pancreatitis in children: clinical analysis of 61 cases in southern Taiwan. Chang Gung Med J 2002;25:162-168.
[PubMed]
27.
Sánchez-Ramírez CA, Larrosa-Haro A, Flores-Martínez S, Sánchez-Corona J, Villa-Gómez A, Macías-Rosales R: Acute and recurrent pancreatitis in children: etiological factors. Acta Paediatr 2007;96:534-537.
[PubMed]
28.
Chen CF, Kong MS, Lai MW, Wang CJ: Acute pancreatitis in children: 10-year experience in a medical center. Acta Paediatr Taiwan 2006;47:192-196.
[PubMed]
29.
Goh SK, Chui CH, Jacobsen AS: Childhood acute pancreatitis in a children's hospital. Singapore Med J 2003;44:453-456.
[PubMed]
30.
Kandula L, Lowe ME: Etiology and outcome of acute pancreatitis in infants and toddlers. J Pediatr 2008;152:106-110.
[PubMed]
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