Chronic relapsing pancreatitis in childhood.

We report 10 children with chronic relapsing pancreatitis. These patients can be divided into three groups, based on their clinical history, manifestations, and radiographic findings. Group 1 includes four patients with hereditary pancreatitis; these patients have had recurrent abdominal pain since early childhood, and have a positive family history for pancreatitis. Group 2 includes two patients with clinical and radiographic findings similar to those in patients with hereditary pancreatitis but without a family history of pancreatitis. Group 3 includes four patients with fibrosing pancreatitis who had symptoms and signs of obstructive jaundice. Our report emphasizes three points: (1) that chronic pancreatitis does occur in young children and is most commonly caused by hereditary pancreatitis or fibrosing pancreatitis; (2) that endoscopic retrograde cholangiopancreatiography is a safe and valuable tool for the study of pancreatic and common bile ducts; and (3) that surgical intervention is indicated to drain the pancreatic duct in patients with hereditary pancreatitis, and sphincterotomy is an effective therapy for patients with fibrosing pancreatitis.