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The role of acute pancreatitis in pediatric burn patients
Haidy G Rivero1, Jong O Lee, David N Herndon
1Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Insights
Acute pancreatitis is a rare complication in pediatric burn patients, occurring in 0.05% of cases. However, this condition significantly increases mortality, highlighting the need for early detection and management in burned children.
Area of Science:
- Pediatric Surgery
- Critical Care Medicine
- Gastroenterology
Background:
- Acute pancreatitis (AP) is an underrecognized complication following severe burns in children.
- Limited data exists on the incidence, morbidity, and mortality of AP in this vulnerable population.
Purpose of the Study:
- To determine the incidence, morbidity, and mortality of AP in pediatric burn patients.
- To correlate clinical diagnoses with autopsy findings for unrecognized AP.
- To assess the impact of AP on mortality in pediatric burn survivors.
Main Methods:
- Retrospective review of 2699 pediatric burn patient records.
- Defined AP by clinical symptoms (abdominal pain/feeding intolerance) and elevated amylase/lipase (≥3-fold).
- Evaluated autopsy reports of 78 deceased pediatric burn patients for evidence of pancreatic inflammation and necrosis.
Main Results:
- AP occurred in 13 of 2699 pediatric burn patients (0.05% incidence).
- Mortality was significantly higher in the AP group compared to controls (p < 0.05).
- Autopsy confirmed pancreatitis in 11 of 78 patients (0.17% incidence).
Conclusions:
- Despite its low incidence, AP is associated with increased mortality in severely burned children.
- Increased vigilance in evaluating and treating AP in pediatric burn patients is crucial.
- Early recognition and management of AP may improve outcomes in pediatric burn care.
Abstract:
Few publications recognize acute pancreatitis as a complication after large burns, consequently the incidence and outcome acute pancreatitis after burn in children is not well defined. The aim of this study was to determine the incidence, morbidity, and mortality relating to acute pancreatitis in a pediatric burn population and to correlate clinical diagnosis with autopsy findings to determine the incidence of unrecognized pancreatitis. Records of 2699 patients with acute burns were reviewed. Acute pancreatitis was defined as abdominal pain and/or feeding intolerance in addition to a three-fold elevation of amylase and/or lipase. One-hundred twenty-seven burned children served as the control cohort. To assess the presence of autopsy confirmed AP in pediatric burn patients, we evaluated autopsy reports of 78 children who died from burns, looking for reported evidence of pancreatic inflammation, and fat/parenchymal necrosis. Our data show that acute pancreatitis in children has a low incidence after burn. The study included 2699 patients of which 13 were suffering acute pancreatitis (13/2699 = 0.05%). Mortality is significantly higher for the acute pancreatitis group vs. the control group, p < 0.05. Autopsy reports established 11 of 78 patients with evidence of pancreatitis, resulting in an incidence of 0.17% for pancreatitis at autopsy. Although it has low incidence, acute pancreatitis is associated with increased mortality in severely burned pediatric patients, which underlines the importance of increased vigilance in the evaluation and treatment of pancreatitis in burned children.
Related Concept Videos
01:25Acute Pancreatitis I: Introduction
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:21Acute Pancreatitis II: Pathophysiology
01:25Chronic Pancreatitis I: Introduction
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...