Publications

BACKGROUND: /Objective: The extent of exocrine pancreatic insufficiency (EPI) in the paediatric population with acute pancreatitis (AP) is unknown. The primary  objective was to use a 6 h stable-isotope breath test to determine the prevalence  of EPI in children with AP. The secondary objective was to determine the  diagnostic ability of a 4 h abbreviated breath test in the detection of EPI.  METHODS: (13)C-mixed triglyceride (MTG) breath test was used to measure fat  digestibility in 12 children with AP and 12 normal children. EPI was diagnosed  based on a cumulative dose percentage recovery (cPDR) cut-off value < 26.8%  present in literature. To reduce the test burden, the diagnostic accuracy of an  abbreviated 4 h test was evaluated, using a cPDR cut-off that was the 2.5(th)  percentile of its distribution in control children. RESULTS: The cPDR of cases  was significantly lower than that of controls (27.71 ± 7.88% vs 36.37 ± 4.70%,  p = 0.005). The cPDR during acute illness was not significantly different to that  at 1 month follow up (24.69 ± 6.83% vs 26.98 ± 11.10%, p = 0.52). The 4 h and 6 h  breath test results correlated strongly (r = 0.93, p < 0.001) with each other.  The new 4 h test had 87.5% sensitivity and 93.8% specificity for detecting EPI.  CONCLUSION: Two-thirds (66.7%) of this sample of children with AP had EPI during  admission, which persisted at 1 month follow up. The 4 h abbreviated (13)C-MTG  breath test has good diagnostic ability to detect EPI in children and may improve  its clinical utility in this age group.