Pancreatitis Clinical Pathway, Emergency Department and Inpatient – Cohort

Pancreatitis Clinical Pathway — Emergency Department and Inpatient

Child with Suspected or Known Non-Traumatic Pancreatitis

This pathway guides the evaluation and treatment of children with:

  • 1st episode of acute pancreatitis
  • Acute recurrent pancreatitis
  • Abdominal pain and a history of ARP or chronic pancreatitis

Acute pancreatitis diagnosis requires 2 of the following:

  1. Abdominal pain consistent with pancreatic origin (acute, epigastric)
    • Young children may not have or be able to express characteristic pain
  2. Elevated serum amylase or lipase ≥ 3x the upper limit of normal
  3. Imaging findings compatible with pancreatic inflammation (CT, MR, US)

Acute recurrent pancreatitis diagnosis requires:

  • At least 2 distinct episodes of acute pancreatitis as defined above
  • Distinct episodes are defined by either:
    • ≥ 1 mo without symptoms or
    • Resolution of symptoms and normalization of enzymes regardless of interval

Exclusions

  • Known underlying metabolic disorder
  • Diabetic ketoacidosis (DKA)
  • Known gallstone pancreatitis