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Long-Term Follow-Up and Outcome of Pediatric Acute Pancreatitis: A Multicenter Study
Burcu Volkan1, Bilge Şahin Akkelle1, Nevzat Aykut Bayrak2
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Marmara University Faculty of Medicine, İstanbul, Turkey.
Insights
Childhood acute pancreatitis admissions are rising, but hospital stays are shorter. Early genetic testing and imaging are recommended for children with risk factors to prevent progression to chronic pancreatitis.
Area of Science:
- Pediatric Gastroenterology
- Pancreatology
- Clinical Epidemiology
Background:
- The incidence of acute pancreatitis is increasing globally.
- Progression patterns of childhood acute recurrent pancreatitis and chronic pancreatitis remain under-documented.
- Understanding pediatric pancreatitis progression is crucial for timely intervention.
Purpose of the Study:
- To delineate the temporal changes in childhood pancreatitis.
- To analyze the progression of acute pancreatitis to acute recurrent pancreatitis and chronic pancreatitis in children.
- To identify risk factors associated with pancreatitis progression.
Main Methods:
- Multicenter retrospective study.
- Inclusion of 165 pediatric patients hospitalized with acute pancreatitis between 2010 and 2017.
- Review of clinical characteristics and disease progression.
Main Results:
- Increased rate of acute pancreatitis admissions observed over the study period.
- Decreased duration of hospitalization for acute pancreatitis.
- Nearly two-thirds of cases resolved spontaneously; 30.9% developed acute recurrent pancreatitis and 4.3% chronic pancreatitis. 27.4% of acute recurrent pancreatitis cases progressed to chronic pancreatitis.
- Local complications occurred in 13.3% of patients.
Conclusions:
- Confirmed rising incidence of childhood acute pancreatitis, with reduced hospital stay duration.
- Pancreaticobiliary abnormalities and genetic factors significantly increase progression risk.
- Recommend early genetic testing and radiological imaging for at-risk pediatric pancreatitis patients.
Objective:
Over the past decades, the incidence of acute pancreatitis is increasing, but the progression of acute recurrent pancreatitis and chronic pancreatitis is still not well documented in children. The aim of this multicenter study is to delineate the changes that occur in a certain time period in the course of childhood pancreatitis.
Materials And Methods:
The data of consecutive patients hospitalized with acute pancreatitis between 2010 and 2017 in 4 different pediatric gastroenterology units were reviewed. The clini- cal characteristics of the disease were defined.
Results:
A total of 165 patients (55.2% female) were included. Over the years, the rate of acute pancreatitis admissions increased while the duration of hospitalization decreased (P < .05). Nearly two-thirds of the patients with acute pancreatitis resolved spontaneously, 30.9% and 4.3% of the cases developed acute recurrent pancreatitis and chronic pancreatitis, respectively. Furthermore, 27.4% patients with acute recurrent pancreatitis progressed to chronic pancre- atitis, and eventually, 12.7% of cases developed chronic pancreatitis within 3-4 years. Local complications developed in 13.3% of the patients with pancreatitis in this cohort.
Conclusion:
The result of this study confirmed the increased incidence of acute pancreatitis in recent years. Conversely, the length of hospital stay decreased over the years. Patients with pancreaticobiliary abnormalities or genetic risk factors had a higher rate of progression to acute recurrent pancreatitis or chronic pancreatitis. Therefore, genetic testing and radiological imaging should be considered early in the follow-up of patients with acute pancreatitis having risk factors for progression to acute recurrent pancreatitis/chronic pancreatitis.
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