[Acute pancreatitis in pediatric age: our experience in 52 cases]

The aim of this study was to report our experience about clinical presentation and management in children with mild and sever acute pancreatitis (PA).

At the onset of clinical manifestations the following laboratory and instrumental tests were performed to all patients: abdominal ultrasonography, measurement of blood amylase and lipase and PCR; preventive antibiotic therapy, gabexate mesylate and proton pump inhibitors were also administrated to all patients. During the follow-up CT and dosage amylase and lipase in blood were performed.

Results summarize data of 52 patients with suspected diagnosis of acute pancreatitis admitted to our hospital within 24 h of symptoms (from January 2008 to December 2011). Age ranged between 4-18 years, and the study included 30 females and 22 males. According to Santorini Consensus Conference, 40 patients were defined having a mild and 12 a severe pancreatitis. All patients with mild PA underwent a medical and/or surgical treatment (endoscopic retrograde cholangiopancreatography, laparoscopic cholecystectomy); there were 2 fatalities between patients with severe PA and 2 cases of pancreatic pseudocyst treated with guided CT drainage and therapy with octreotide. All patients had abdominal pain but the location, severity and duration of pain were extremely variable. Blood dosage of amylase was altered in 83% of cases and of lipase in 100%. Ultrasonography showed abnormalities in 89% of the patients and TC showed alterations of pancreatic parenchyma in 100% of the cases when performed at 48 h.

In absence of randomized controlled studies, systematic review or guidelines for diagnosis and management of PA in pediatric age we used our experiences on adult patients, aware of this approach limitation.