hungarian pancreatic study group – magyar hasnyálmirigy munkacsoport dóra mosztbacher on behalf...
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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
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