| Theme |
Gastrointestinal Endoscopy in Children |
| Title |
Pancreaticobiliary Diseases in Children |
| Author |
Tsuyoshi Sogo |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| Author |
Kentaro Masuzawa |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| Author |
Shuichiro Umetsu |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| Author |
Tomoyuki Tsunoda |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| Author |
Ayano Inui |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| Author |
Tomoo Fujisawa |
Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama City Tobu Hospital |
| [ Summary ] |
Pancreaticobiliary diseases in childhood are varied. Some are based on congenital abnormalities and are diagnosed in the neonatal period, and others without obvious symptoms are diagnosed by chance. However, pediatric pancreaticobiliary diseases that require endoscopic diagnosis or treatment are limited compared to those in adults. Primary sclerosing cholangitis (PSC) is characterized by multiple strictures and dilatations of the bile duct. Endoscopic retrograde cholangiopancreatography (ERCP) is necessary for diagnosing PSC, particularly in childhood. Although many pancreaticobiliary diseases can be diagnosed by noninvasive examinations because of the recent developments in imaging modalities, there are some diseases that require ERCP for diagnosis. For example, some cases of biliary atresia present with an atypical course, making it difficult to differentiate from other infantile cholestatic diseases using ultrasound examination or scintigraphy alone. In such cases, ERCP might be useful prior to surgical procedures. ERCP can be also useful to evaluate pancreaticobiliary maljunction in detail before surgery. For example, for some cases of unexplained pancreatitis with normal magnetic resonance cholangiopancreatography (MRCP), ERCP might reveal pancreaticobiliary maljunction. Because there are a limited number of institutions in which ERCP for children can be performed, the diagnosis of pediatric pancreaticobiliary diseases might be inadequate. |