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BACKGROUND

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Acute pancreatitis, the most common pancreatic disorder in childhood,1,2 is a costly and increasingly recognized disease. Studies from the United States, Mexico, and Australia have reported an increasing incidence of pediatric acute pancreatitis over the past two decades, though the reasons for such increases remain unclear.3-9 In the United States, approximately 11,000 children are diagnosed with acute pancreatitis each year, providing a total fiscal burden of more than $200 million/year. The burden, however, is not limited to cost, as pediatric acute pancreatitis is associated with significant morbidity and mortality, with reported mortality rates ranging from 0% to as high as 11%. The incidence of acute pancreatitis is 2 to 13 new cases annually per 100,000 children.4,7,10

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ETIOLOGY

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Acute pancreatitis is a reversible process characterized by the presence of interstitial edema, infiltration by acute inflammatory cells, and varying degrees of necrosis, apoptosis and hemorrhage.4,11 There are many causes of acute pancreatitis (Table 82-1), but the mechanisms by which these conditions trigger pancreatic inflammation have not been fully elucidated.

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TABLE 82-1Causes and Conditions Associated with Pancreatitis
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While gallstones and alcohol consumption cause most cases in adults, the etiologies in children are more ...

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