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Acute pancreatitis in children: A single center experience over ten years
Elif Sağ1, Gülay Kaya2, Elif Bahat-Özdoğan3
1Departments of Pediatric Gastroenterology, Hepatology and Nutrition, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
Insights
Acute pancreatitis in children is often mild, but its incidence is rising. Factors like male gender and certain diseases increase the risk of recurrent acute pancreatitis (RAP) in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Medicine
Background:
- Acute pancreatitis (AP) is an inflammatory condition affecting the pancreas, presenting with abdominal pain and elevated pancreatic enzymes.
- Recent reports indicate an increasing incidence of AP in pediatric populations.
- Understanding the characteristics and risk factors of AP in children is crucial for effective management.
Purpose of the Study:
- To analyze the demographic characteristics, etiology, outcomes, and incidence of AP in hospitalized children.
- To identify factors associated with recurrent acute pancreatitis (RAP) in pediatric patients.
- To assess trends in AP incidence over a ten-year period.
Main Methods:
- Retrospective analysis of medical records of 63 children diagnosed with AP between January 2005 and December 2015.
- Data collected included patient demographics, etiology, disease severity, complications, and follow-up information.
- Statistical analysis was performed to identify risk factors for RAP and assess incidence trends.
Main Results:
- The primary etiologies identified were systemic diseases (14.3%), trauma (11.1%), and cholelithiasis (9.5%).
- The majority of cases were mild (54%), with moderately severe (28.6%) and severe (17.4%) AP also observed. Organ dysfunction occurred in 17.4% of patients.
- Male gender, local pancreatic or systemic complications, metabolic, and hereditary diseases were significantly associated with an increased risk of RAP (p < 0.05).
- The incidence of AP among hospitalized patients increased significantly from 2009-2010 to 2015-2016 (OR: 4.1, p=0.0002).
- The overall mortality rate associated with AP was 4.84%.
Conclusions:
- Acute pancreatitis in children is generally a mild condition, but its incidence among hospitalized children is on the rise.
- Male gender, initial complications, and underlying metabolic or hereditary diseases are significant risk factors for recurrent AP in pediatric patients.
- Continued surveillance and research are warranted to understand and manage the increasing incidence and risk factors of pediatric AP.
Abstract:
Sağ E, Kaya G, Bahat-Özdoğan E, Karahan SC, İmamoğlu M, Sarıhan H, Çakır M. Acute pancreatitis in children: A single center experience over ten years. Turk J Pediatr 2018; 60: 153-158. Acute pancreatitis (AP) is an inflammatory disease characterized by sudden onset abdominal pain together with elevation of pancreatic enzymes and radiographic changes. Increased incidence of AP in children have been reported in recent reports. In this study; we aimed to analyze the demographic characteristics, etiology, outcome and incidence of AP among hospitalized children in our center. Medical records of the children with AP since January 2005 were analyzed from hospital files (N=63). Major etiologies were systemic diseases (14.3%), trauma (11.1%), cholelithiasis (9.5%); 54% (N=34) of the patients had mild AP, while 28.6% (N=18) had moderately severe AP and 17.4% (N=11) had severe AP. Organ dysfunction was found in 11 patients (17.4%) at initial examination. During the follow-up period (68.1±24.3 months), 10 patients (15.9%) experienced 24 recurring AP (RAP) attacks. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic and hereditary diseases were associated with the increased risk of RAP (p < 0.05 for all). The mortality rate associated with AP was 4.84%. There was an increase in the incidence of AP since 2010 (9.57 in 2009-2010 vs. 39.17/10,000 patients in 2015-2016 years; p=0.0002; OR: 4.1) among the hospitalized patients. Our results indicate that AP is a mild disease in children and the incidence is increasing among hospitalized children. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic diseases and hereditary diseases were associated with the increased risk of RAP.
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