๐Ÿ”„ Section 399.2: Acute Recurrent and Chronic Pancreatitis

Nelson Textbook of Pediatrics 22nd Edition โ€” Acute recurrent pancreatitis (ARP): โ‰ฅ2 distinct episodes with return to baseline. Chronic pancreatitis (CP): irreversible fibrosis, calcifications, ductal abnormalities, exocrine/endocrine insufficiency. Genetic causes: PRSS1 (hereditary), SPINK1, CFTR, CTRC. Anatomic: pancreas divisum. Management: pain control, PERT for insufficiency, endoscopic therapy (ERCP, ESWL), surgery (Frey, Puestow) for refractory pain.

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๐Ÿ“‹ 30 Clinical Scenarios โ€” Recurrent & Chronic Pancreatitis

๐Ÿ“‡ Highโ€‘Yield Review Cards (Recurrent & Chronic Pancreatitis)

๐Ÿฉบ Clinical Presentations: Recurrent & Chronic Pancreatitis

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๐Ÿ“‹ Stepwise Evaluation & Management of ARP & CP

๐Ÿ”‘ Key Principles โ€” Recurrent & Chronic Pancreatitis (Nelson 399.2)
โ€ข Acute recurrent pancreatitis (ARP): โ‰ฅ2 episodes of AP with return to baseline between episodes.
โ€ข Chronic pancreatitis (CP): Irreversible fibrosis, calcifications, dilated ducts, exocrine/endocrine insufficiency.
โ€ข Genetic causes: PRSS1 (hereditary, autosomal dominant), SPINK1 (modifier), CFTR (CFTR-related pancreatitis), CTRC, CPA1.
โ€ข Anatomic causes: Pancreas divisum (most common), annular pancreas, pancreatic duct stricture.
โ€ข Diagnosis: MRCP, EUS, CT for calcifications. Genetic testing.
โ€ข Management โ€” CP: Pain control, PERT for exocrine insufficiency, fat-soluble vitamins, treat diabetes. Endoscopic therapy (ESWL, stenting). Surgical drainage (Frey, Puestow) or resection for refractory pain.

    โšก Reflex Prompts โ€” Recurrent & Chronic Pancreatitis

    ๐Ÿ“– Recurrent & Chronic Pancreatitis โ€” Core Summary