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Etiology of Acute Recurrent Pancreatitis in Vietnamese Children: an Initial Report
Ha Van Thieu1, Ho Quoc Phap2, Mai Tan Lien Bang3
1Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Insights
Acute recurrent pancreatitis (ARP) in children is not rare, often requiring multiple hospital admissions. Biliary tract diseases are the most frequent cause, followed by pancreatic abnormalities and genetic mutations.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Epidemiology
Background:
- Acute recurrent pancreatitis (ARP) presents a significant clinical challenge in pediatric populations.
- Understanding the epidemiological profile of ARP is crucial for effective management and resource allocation.
Observation:
- A case series study at Children's Hospital 2, Vietnam, analyzed 33 pediatric ARP cases from 2014-2019.
- The mean age of first onset was 7.3 years, with a male to female ratio of 1.2:1.
- Abdominal pain and vomiting were the predominant symptoms leading to hospitalization.
Findings:
- Biliary tract disease, including choledochal cysts and gallstones, was the leading etiology (51.5%).
- Pancreatic structural abnormalities (18.2%) and genetic mutations (15.2%) were also identified as significant causes.
- Patients experienced a median of 3 ARP admissions, with a median interval of 168 days between hospitalizations.
Implications:
- ARP is a recurring condition in children, necessitating comprehensive diagnostic approaches.
- Early identification of etiological factors, such as biliary disease and genetic predispositions, is vital for targeted interventions.
- This study highlights the need for increased awareness and specialized care for pediatric ARP in resource-limited settings.
Objectives:
The aim of this study was to describe the epidemiological characteristics of acute recurrent pancreatitis (ARP) among children who were admitted at Children's Hospital 2, Ho Chi Minh City, Vietnam, from May 2014 to May 2019.
Methods:
Authors presented Case series study.
Results:
A total of 33 cases met the criteria for study inclusion. The mean age of first onset 7.3 ± 4.4 years (range, 1.4-15 years), the male to female ratio was 18:15 (1.2:1). The median number of ARP admissions per patient was 3 (range, 2-14), and the median time between ARP-related hospitalization was 168 days (range, 82-240 days). The chief complaint upon hospitalization was abdominal pain, accounting for 96.9% of cases, vomiting in 87.9% of cases, and severe ARP was observed in 24% of cases. All patients underwent magnetic resonance cholangiopancreatography (MRCP), and abdominal computed tomography (CT) scans. Genetic testing was performed in 14 of 33 cases, and 5 cases had at least 1 mutation, whereas 9 were negative. The most common etiology of ARP was biliary tract disease, in 17 cases (51.5%; 11 choledochal cysts, 6 gallstones), abnormalities of the pancreas were observed in 18.2% (abnormalities of pancreatic structures in 3 cases), hypertriglyceridemia and metabolic disease were observed in 6.1% of cases, and genetic mutations were identified in 15.2% of cases.
Conclusion:
ARP is not a rare disease, and ARP patients may be admitted to the hospital many times. The chief complaints resulting in hospitalization were abdominal pain and vomiting. The most common causes were biliary tract diseases (bile duct cysts in 33.3% and gallstones in 18.2% of cases), with abnormalities of the pancreatic structure identified in 9.1% of cases, and genetic mutations detected in 15.2% of patients.
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