PANCREATIC DISEASE IN CHILDREN AND YOUNG-ADULTS - EVALUATION WITH CT

In children with pancreatic disease, computed tomography (CT) has a pr imary role in the evaluation of pancreatitis, trauma, and malignancy. At CT, pancreatic abnormalities may manifest as pancreatic enlargement (tumor, acute pancreatitis), pancreatic atrophy (cystic fibrosis, chr onic pancreatitis), cystic lesions (pseudocysts, congenital simple cys ts, autosomal dominant polycystic kidney disease, von Hippel-Lindau di sease, cystic fibrosis, cystic neoplasms), or fatty replacement (cysti c fibrosis, Shwachman-Diamond syndrome, history of steroid therapy, Gu shing syndrome, Johanson-Blizzard syndrome, obesity). CT is the best m odality for evaluation of pancreatitis, allowing detection of pancreat ic abnormalities as well as abnormal extrapancreatic fluid collections . In children who have undergone blunt abdominal trauma, CT has been s hown to be the best initial imaging study, being more sensitive than u ltrasound for detection of pancreatic injury. In neoplastic conditions , CT demonstrates the extent of disease, enables characterization of t he tissue components of the tumor, and allows accurate posttreatment f ollow-up. Although the various diseases of the pancreas may have overl apping appearances at CT, the correct diagnosis can often be made on t he basis of the CT findings in combination with the clinical history, laboratory data, and the patient's age.