Functional pancreatic sphincter dysfunction (FPSD), also known as pancreatic sphincter of Oddi dysfunction, is an uncommon cause of pancreatitis. The majority of research was conducted on adults, with drinking or smoking as confounders, both of which were uncommon risk factors in children. There were no diagnostics in pediatrics that can effectively identify FPSD, and it’s unknown how much this illness contributes to childhood pancreatitis. 

Researchers conducted a literature review on the diagnosis and therapeutic techniques for FPSD, taking into account the special issues that pediatrics presents. They identified best practices in the care of children suspected of having FPSD and produced an expert consensus view. 

They proposed that additional risk factors, particularly obstructive variables, be tested out in children with acute recurrent pancreatitis (ARP) or chronic pancreatitis (CP) before considering FPSD as the underlying etiology. In the absence of any obstructive condition, FPSD may be the etiology of a chronically dilated pancreatic duct in children with ARP/CP. When FPSD is highly suspected and alternative etiologies were effectively ruled out, endoscopic retrograde cholangiopancreatography with sphincterotomy should be considered in a limited group of children with ARP/CP. The risks and benefits of endoscopic intervention should be extensively discussed with the patient’s family. When pancreatic ductal dilatation is absent, endoscopic retrograde cholangiopancreatography for suspected FPSD should be considered with care in children with ARP/CP.

Expert consensus recommendations give a consistent approach to pediatric FPSD diagnosis and treatment. More study is needed to identify the entire impact of FPSD on pediatric pancreatitis.