Pancreatitis Clinical Pathway — Emergency Department and Inpatient

Definition of Pancreatitis Types

	Characteristics	Most Common Etiologies	Additional Considerations
Acute Pancreatitis	Abdominal pain that may radiate to the back Lipase elevated > 3x upper limit of normal Imaging consistent with pancreatitis	Idiopathic Viral/infectious Gallstones Medications Valproic acid Tetracyclines, metronidazole NSAIDs Steroids 6-mercaptopurine, methotrexate, PEG-asparaginase Furosemide Doxycycline HUS Trauma IBD Duodenal hematoma	Inflammatory disorders Autoimmune disorders Toxin exposure Medication/drug exposures and side effects Hepatobiliary diseases Anatomical abnormalities
Acute Recurrent Pancreatitis	Bouts of pancreatitis with complete resolution of symptoms and laboratory, imaging finding improvements in between bouts, with > 1 mo interval between bouts May have lipase elevations Imaging findings with prior evidence of pancreatitis like fibrosis, calcifications	Hereditary CFTR, SPINK1, PRSS1, CASR, CPA1, CTRC Anatomical Gallstones Choledochal cysts Pancreas divisum Cholelithiasis Cholecystitis Metabolic Hypertriglyceridemia Hypercalcemia DKA, MMA, propionic acidemia	May see transient or permanent loss of exocrine/digestive pancreatic function
Chronic Pancreatitis	Chronic abdominal pain Possible symptoms of exocrine pancreatic insufficiency Imaging findings c/w chronicity	Transplant/GVHD/BMT Hereditary, Metabolic See above Anatomical See above Pancreatic duct strictures	Likely permanent loss of exocrine/digestive pancreatic function

Reference

Classification of Acute Pancreatitis in the Pediatric Population: Clinical Report From the NASPGHAN Pancreas Committee (2017)

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

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Pancreatitis Clinical Pathway — Emergency Department and Inpatient

Definition of Pancreatitis Types

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Pancreatitis Clinical Pathway, Emergency Department and Inpatient – Types

Pancreatitis Clinical Pathway — Emergency Department and Inpatient

Definition of Pancreatitis Types

Reference