Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Dóra Mosztbacher

on behalf ofthe Hungarian Pancreatic Study Group

SZEKSZÁRD, HUNGARY

Pain IN EArly phase of Pediatric Pancreatitis 

 Pain in early phase of pediatric pancreatitis

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups

PINEAPPLE

PINEAPPLE

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

1. The protocols have been discussed  in our  latest  international meeting held  in Szeged in November 2014, where expert pediatric pancreatologists attended. (http://pancreas.hu/sites/info/files/conferences/ALPD2014-Program.pdf) 

2. The studies have received the relevant ethical approval (No. ad.52499-3/2014) issued by the National Hungarian Ethical Authority (ETT TUKEB).

3. The  trials  have  been registered at the ISRCTN registry (ISRCTN35618458, ISRCTN89664974)  which  is  a  primary  clinical  trial  registry recognized by WHO and ICMJE. 

4. The studies are open for all pediatric centers throughout the world.5. Electronic CRF has been developed.6. The IAP Scientific Committee has approved the  studies  and  advertised 

worldwide among its 4000 members (16.06.2015)7. The TRIAL articles (prestudy protocol) are under review

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

appendicitis

invagination

trauma

malrotation

inguinal hernia

adhesio

NEC

Hirschprung 

ectopic pregnancy

peptic ulcus

uroinfectionPID

ruptured ovarial cyst

menstruation

DKAHUS

myocarditis

obstipation gastroenteritis

Streptococcus pharyngitis

pneumonia

mesenterial lymphadenitis

IBDpancreatitis

cholecystitis

IBD

abd. abscess

malabsorption

HSP

nutritiv allergyhepatitis

Meckel diverticulumurolythiasis

tumor

ovarial/testicle torsion

Sickle cell anaemia

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

1. In case of abdominal pain we should think about it

2. Diagnosis: 2/3 rule2/3 rule

(Under 3 years old just 30% of patients have complains)

Pancreatic oedema by abdominal imaging

(Morinville VD, Pancreas 2010; 39:5-8)

(INSPPIRE, JPGN 2012;55:261-265)

Abdominal pain Elevated pancreatic enzyme levels (3 times upper than the

normal)

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

Rising incidence Rising incidence in the last 15 years (3.6 and 13.2 cases per 100,000 children).

Pancreatitis is NOT a rareis NOT a rare  disease in childhood!

the cause is not clearly understood, probably multifactorial

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

The pediatric pancreatitis is a RARELY DIAGNOSED RARELY DIAGNOSED disease in Central- and Eastern Europe

Reasons:

The incidence of the disease rises from Eastern- to Western Europe.

Financial difficulties

We do not think about pancreatitis

There are no EBM guidelines available

The number of serum amylasThe number of serum amylase/e/ lipase measurement correlates lipase measurement correlates

with the incidence of the diseasewith the incidence of the disease! ! (Morinville VD, JPGN; 2012)

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE-R

RETROSPECTIVELYRETROSPECTIVELY look into our diagnostic practice by overviewing 1-month patient flows of medical and

surgical emergency units.

The number of serum amylase and lipase measurement correlates with the 

incidence of the disease. It will decrease from Western to Eastern Europe

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups

According to patients data, the PINEAPPLE-R excel table PINEAPPLE-R excel table should be filled in and 

sent.

Diagnosis

Abdominal painNauseaVomitingPancreatic enzyme measurementsImaging

Yes or No

PINEAPPLE-R

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE

To provide a fast, simple and authentic scoring system fast, simple and authentic scoring system

that helps to evaluate (in a reliable and cost efficient way) the necessity of pancreatic enzyme test and abdominal ultrasonography or CT when a child has abdominal pain. 

WE HOPEFULLY WILL BE ABLEWE HOPEFULLY WILL BE ABLE to draft the score system

PINEAPPLE-P

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups

The patient needs to be informed and the ““PINEAPPLE-P PINEAPPLE-P InformedInformed consent form”consent form”

needs to be signed. 

““PINEAPPLE-P PINEAPPLE-P ENG FORM-A” ENG FORM-A” questionnaire

PINEAPPLEPINEAPPLE-P

Hungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLEPINEAPPLE-P

Thank you for joining to us!

We are waiting for more We are waiting for more centres!!!centres!!!

THE HUNGARIAN PANCREATIC STUDY GROUPIS COMMITTED TO IMPROVING

THE LIVE OF PATIENTS SUFFERING FROM PANCREATIC DISEASES!

www.pancreas.huHungarian Pancreatic Study Group – Magyar Hasnyálmirigy Munkacsoport

Pain IN EArly phase of Pediatric Pancreatitis 

 

4th Conference of the Hungarian & 2nd Conference of the Eastern and Central European Pancreatic Study Groups PINEAPPLE