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Disease progression of acute pancreatitis in pediatric patients
Fabao Hao1, Hongjie Guo1, Qianfu Luo1
1Department of Pediatric General Surgery and Liver Transplantation, Children's Hospital, Chongqing Medical University, Chongqing, P.R. China.
Insights
Recurrent acute pancreatitis (AP) is more common in patients with idiopathic AP. Recurrence increases the risk of developing chronic pancreatitis, with more episodes leading to higher risk.
Area of Science:
- Gastroenterology
- Pancreatology
- Clinical Medicine
Background:
- Approximately 10% of acute pancreatitis (AP) cases progress to chronic pancreatitis.
- Factors influencing recurrent pancreatitis after an initial episode remain poorly understood.
- This study investigates outcomes and predictors of disease progression in AP patients.
Purpose of the Study:
- To identify predictors of recurrent acute pancreatitis (RAP).
- To determine factors associated with the progression from AP to chronic pancreatitis.
- To analyze the relationship between AP severity, etiology, and recurrence.
Main Methods:
- Retrospective analysis of 159 first-time AP patients (July 2003 - June 2015).
- Data collected on AP etiology, severity (Atlanta classification), and recurrence.
- Logistic regression used to identify independent predictors of RAP and chronic pancreatitis.
Main Results:
- 45% of patients developed RAP; 5.7% developed chronic pancreatitis.
- Idiopathic first-time AP and severe ascites, pancreatic necrosis, and systemic complications predicted RAP in pediatric patients.
- More than two RAP episodes predicted progression to chronic pancreatitis.
Conclusions:
- Severity and idiopathic nature of first-time AP are linked to RAP.
- Recurrence of AP elevates the risk of developing chronic pancreatitis.
- Increased number of AP episodes correlates with a higher risk of recurrence.
Background:
Approximately 10% of patients with acute pancreatitis (AP) progress to chronic pancreatitis. Little is known about the factors that affect recurrence of pancreatitis after an initial episode. We retrospectively investigated patients with AP, focusing on their outcomes and the predictors for disease progression.
Methods:
Between July 2003 and June 2015, we retrospectively enrolled first-time AP patients with medical records on disease etiology, severity (according to the Atlanta classifications), and recurrence of AP. Independent predictors of recurrent AP (RAP) and chronic pancreatitis were identified using the logistic regression model.
Results:
Of the total 159 patients, 45 (28.3%) developed RAP, including two episodes of RAP in 19 patients, and 9 (5.7%) developed chronic pancreatitis. The median duration from the time of AP to the onset of RAP was 5.6 ± 2.3 months. RAP patients were identified as more common among patients with idiopathic first-time AP. The presence of severe ascites, pancreatic necrosis, and systemic complications was independent predictors of RAP in pediatric patients. Experiencing over two RAP episodes was the predictor for developing chronic pancreatitis. No influence of age or number of AP episodes was found on the occurrence of abdominal pain, pain severity, and the prevalence of any pain.
Conclusions:
Severity of first-time AP and idiopathic first-time AP are related to RAP. Recurrence increases risk for progression to chronic pancreatitis. The risk of recurrence increased with increasing numbers of AP episodes.
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