A review of acute pancreatitis in the era of COVID-19

Acute pancreatitis is uncommon in childhood with an estimated incidence of approximately 1 in 10,000 children per year. It is an important condition, which may escape prompt diagnosis and is associated with significant morbidity and mortality. Most often, it will result in an acute hospital admission. The course of this disease is unpredictable and ranges from self-resolving mild illness to significantly severe disease with high risk of mortality or complications due to progression to multiorgan failure. Considerable advances have occurred in management which is now focused on multidisciplinary approach with extensive investigation and minimally invasive endoscopic interventions resulting in improved prognosis. In recent years, incidence of acute pancreatitis in children has risen, either due to improved awareness or reflective of true rise. Since 2020 there are emerging data suggesting an association of COVID-19 with acute pancreatitis. The best approach to diagnosis and management of acute pancreatitis in children and young people is largely extrapolated from adult practice. This review presents a brief summary of normal physiology and pathophysiology relating to pancreatitis, a suggested approach to investigation and diagnosis and summarizes available evidence to inform management in children and young people. We will also explore the latest data collected linking COVID-19 to pancreatitis.