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The aim of the present work is to provide a new classification of the exocrine pancreatic diseases in childhood by means of a simple and practicable scheme which is in line with the recognized classification of Internal Medicine. The article presents a definite distinction between organic diseases of the pancreas -- such as deformities, congenital insufficiences, pancreatitis, cysts and tumors -- functional disturbances of the pancreas secretion and pseudo-pancreas insufficiency caused by extrapancreatic factors. New investigative methods help to distinguish between various disorders encountered.

43 gastroenterologically healthy infants and children as well as 45 patients with different malabsorption and maldigestion syndromes were investigated during the basic secretion and after injection of secretin and pancreozymin in order to establish the total quantity and also the distribution of the secreted bile acids. The total concentration and quantity were determined enzymatically; column and thinlayer chromatography were utilized to separate the bile into 30 different bile acids. While the total quantity of bile acids was found to be independent of age, the compounding of bile changed during the first years of life. Patients with coeliac disease reacted to injection of peptide hormones by producing a larger volume of secretion than did the control group. Despite the increased secretion there was at the same time a significantly higher concentration of bile acids in the duodenal juice. In this group the analysis of the bile acid distribution indicated no abnormality but striking changes were found in patients with cystic fibrosis, biliary atresia, M. Wilson, and in children after subtotal resection of the small bowel.