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[Acute pancreatitis in children]
O Gómez Beltrán1, L Roldán Molleja, J I Garrido Pérez
1UGC de Cirugía Pedádtrica, Hospital Universitario Reina Sofia, Córdoba. medicinaunosc@hotmail.com
Insights
Acute pancreatitis in children is increasing but often mild. Etiology is diverse, and while serum lipase is crucial for diagnosis, especially with normal amylase, outcomes are generally favorable with no deaths in this study.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Pancreatology
Context:
- Childhood acute pancreatitis incidence is rising.
- Most cases are mild and do not require surgery.
- Multiple etiologic factors contribute to pediatric pancreatitis.
Purpose:
- To assess the etiology, clinical features, and outcomes of acute pancreatitis in children.
- To analyze diagnostic challenges, including normoamylasemia.
- To evaluate treatment approaches and complications in pediatric pancreatitis.
Summary:
- A retrospective review of 24 pediatric acute pancreatitis cases (1998-2010) identified varied causes including idiopathic, biliary disease, and trauma.
- Clinical features included abdominal pain and vomiting; lipase was vital in normoamylasemia cases. Two severe cases involved renal failure and necrosis.
- Six patients underwent surgery; 20.8% experienced complications like pseudocysts. Mean hospital stay was 25.65 days, with no pancreatitis-related deaths.
Impact:
- Highlights the importance of serum lipase and clinical/radiological findings in diagnosing pediatric acute pancreatitis, especially with normal amylase levels.
- Provides insights into the diverse etiology and clinical presentation of acute pancreatitis in children.
- Emphasizes the generally good prognosis for childhood acute pancreatitis, informing clinical management and future research directions.
Introduction:
Lately, there has been an increase in incidence of acute pancreatitis in childhood. Fortunately, 80% of cases are mild and do not require surgical approach. Several etiologic factors have been implicated, such as infections, trauma, congenital anomalies, drugs, biliary diseases. The aim of this study was to assess etiology, clinical features and outcomes of children with acute pancreatitis treated at our center.
Materials And Methods:
A retrospective chart review of our cases of acute pancreatitis in patients younger than 16 years old was performed.
Results:
24 cases of acute pancreatitis were found from 1998 to 2010. Mean age was 8.75 years. There were 7 boys and 17 girls. The main clinical manifestations were abdominal pain, vomiting and abdominal distention. Mean amylase level was 1565 UI/L. There was one patient with normal serum amylase levels. Serum lipase was required in two patients (239 UI/L and 5,980 UI/L). Ultrasound showed pancreatic lesion in 79.2% of cases. Severe pancreatitis was presented in two cases, due to renal failure and pancreatic necrosis. Surgery was performed in 6 cases (3 cholecystectomies, 1 choledocal cyst resection, 1 percutaneous pseudocyst drainage and 1 necrosectomy) Pancreatic complications were found in 20.8% of cases (4 pseudocysts y 1 pancretic necrosis) Several causes were found: idiophatic, secondary to ERCP, congenital anomalies, drugs, infections, biliary disease and trauma. Mean hospital stay was 25.65 days. There were no deaths due to acute pancreatitis.
Conclusions:
There are several causes of acute pancreatitis in children. Some cases may present normoamilasemia, situation, in which serum lipase and clinical and radiological criteria are pivotal. Prospective studies evaluating etiological factors and incidence are required.
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