| Little is known about risk factors for biliary pancreatitis in children. We hypothesized that ethnicity, obesity, and elevated pancreatic and hepatic biomarkers distinguish biliary from non-biliary and gallstone- from sludge-induced pancreatitis. We aimed to (1) characterize pediatric cases of biliary pancreatitis, (2) compare biliary with non-biliary cases, (3) examine differences between younger and older children, and (4) study features that distinguish gallstone- from sludge-induced pancreatitis.;We evaluated 76 episodes of biliary pancreatitis from 271 cases of acute pancreatitis in children admitted to Yale-New Haven hospital from 1994 to 2007. Of the 76 cases, 55% had gallstones, 21% had sludge, and 24% had structural defects. Hispanic children had a 2.85 (p=0.01) and 5.59 (p=0.003) higher probability of being diagnosed with biliary pancreatitis than white and black children, respectively. Median serum amylase and lipase in children with biliary pancreatitis were 64% and 49% higher, respectively, compared to other etiologies (p<0.05). In multiple logistic regression, aspartate aminotransferase (AST) was an independent predictor of biliary pancreatitis (OR=6.69, p=0.001). When comparing gallstone- with sludge-induced etiologies, obesity was an independent predictor (38% more prevalent, p<0.01) of gallstone cases.;Hispanic ethnicity was found to be a risk factor and AST a biomarker for biliary pancreatitis over other etiologies. Furthermore, obesity can distinguish gallstone- from sludge-induced pancreatitis. These findings may spur prospective studies to determine the optimal evaluation and management of children with biliary pancreatitis. |
