Managing pancreatic fluid collections and chronic pancreatitis complications in children

Most pancreatic fluid collections are self-limited and should not be drained unless absolutely necessary.

According to the Atlanta classification, acute problems occur in fluid collections less than 4 weeks old.

Pseudocysts that develop over 4 weeks are either self-limited or amenable to drainage.

Walled-off necrosis with an encapsulated wall and necrotic tissue is problematic and requires specialist consultation.

Chronic pancreatitis is marked by calcifications, atrophy, and ductal irregularities in the pancreatic parenchyma and duct that were not present with acute events.

When imaging findings of chronic pancreatitis appear, pancreatic function will start failing very soon.

Chronic pancreatitis diagnosis requires evidence of abdominal pain consistent with pancreatic origin.

Chronic pancreatitis diagnosis requires evidence of exocrine pancreatic insufficiency.

All patients with chronic pancreatitis have some sort of gastroparesis.

Pseudoaneurysms can occur on the splenic arteries, celiac artery, and SMA in chronic pancreatitis.