🩺 Chapter 399: Pancreatitis (Acute, Recurrent, Chronic)

Nelson Textbook of Pediatrics 22nd Edition — Pancreatitis is inflammation of the pancreas. Diagnosis: abdominal pain + lipase/amylase ≥3x ULN + imaging findings. Etiologies: gallstones, drugs (valproate, L-asparaginase, azathioprine), trauma, genetic (PRSS1, SPINK1, CFTR), autoimmune, idiopathic. Management: IV fluids, analgesia, NPO initially, early enteral nutrition, treat underlying cause, ERCP for gallstone pancreatitis. Severe cases: ICU, necrosectomy if infected necrosis.

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📋 30 Clinical Scenarios — Pancreatitis

📇 High‑Yield Review Cards (Pancreatitis)

🩺 Clinical Presentations: Pancreatitis

Select a presentation for diagnostic clues and management.

📋 Stepwise Evaluation & Management of Pancreatitis

🔑 Key Principles — Pancreatitis (Nelson Ch.399)
• Diagnosis (INSPPIRE criteria): Requires 2 of 3: abdominal pain + lipase/amylase ≥3x ULN + imaging findings (CT/US).
• Common etiologies: Gallstones, drugs (valproate, asparaginase, azathioprine, 6-MP), trauma, genetic (PRSS1, SPINK1, CFTR), autoimmune, post-ERCP, idiopathic.
• Management — Mild acute: IV fluids (lactated Ringer's), analgesia (morphine, fentanyl), NPO initially, early enteral nutrition (low-fat).
• Severe pancreatitis: ICU care, monitor for necrosis, pseudocyst, organ failure. No routine antibiotics.
• ERCP: Indicated for gallstone pancreatitis with cholangitis or persistent obstruction.
• Genetic testing: For recurrent or idiopathic pancreatitis (PRSS1, SPINK1, CFTR, CTRC).

    ⚡ Reflex Prompts — Pancreatitis Clinical Decisions

    📖 Pancreatitis — Core Summary (Nelson Ch.399)