General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. Conflict of Interest:The authors have no conflicts of interest relevant to this article to disclose. What's Known on This Subject: Acute pancreatitis in childhood is a relatively rare but potentially serious condition. In the past, trauma and mumps have been the commonest associations. No study has ever estimated incidence within a childhood population on a prospective basis. AbbreviationsWhat This Study Adds: Acute pancreatitis has a childhood incidence in the UK of 0.78 per 100,000/year (95%CI 0.62-0.96). Gallstones and drug therapy are now the most commonly identified associations whilst mumps and trauma are identified rarely. Children of Pakistani heritage are disproportionately affected. Contributors' Statements:Abdalmonem Majbar: Dr Majbar helped with designing the data collection instruments, collected the data, conducted all analyses, drafted the initial manuscript, and approved the final manuscript as submitted.Eleri Cusick and Paul Johnson: Ms Cusick and Professor Johnson contributed to study conceptualization and design, took part in data interpretation, critically reviewed the manuscript, and approved the final manuscript as submitted.Richard Lynn: Mr Lynn contributed to study conceptualization and design, critically reviewed the manuscript, and approved the final manuscript as submitted.Linda Hunt: Dr Hunt supported and contributed to the statistical analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.Julian Shield: Professor Shield conceptualized and designed the study, supervised and assisted data collection and analyses, critically reviewed the manuscript, and approved the final manuscript as submitted.All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Results: 94 cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3-14.9). White children accounted for 61% of the cases compared to 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the UK was 0.78 per 100,000/year (95%CI 0.62-0.96). The incidence in Pakistani children (4.55; 95%CI 2.60-7.39) was 7-fold greater than White children (0.63; 95%CI 0.47-0.83). Of the 94 cases: 35 (37%) were idiopathic or associated with drugs 18 (19%), gallstones 12 (13%), hereditary 7 (7%), organic acidaemias 7 (7%), anatomical anomalies 5 (5%), viral infections 3 (3%), systemic diseases 2 (2%) and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%) and sodium valproate (17%). Conclusions:Whilst still relatively uncommon in the U...