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The Analysis of the Clinical Course of Acute Pancreatitis in Children-A Single-Center Study
Aleksandra Mroskowiak1, Karolina Majewska2, Zuzanna Symela3
1Department of Paediatrics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
Insights
Pediatric acute pancreatitis (AP) is a serious inflammatory condition. This study found biliary, genetic factors, and anatomical defects are common causes, with increasing diagnoses over time.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Pancreatology
Background:
- Acute pancreatitis (AP) is a complex inflammatory condition affecting the pancreas and surrounding tissues.
- In children, AP causes include trauma, infections, systemic diseases, biliary issues, and genetic mutations.
- AP severity ranges from mild to life-threatening.
Purpose of the Study:
- To retrospectively analyze the causes, clinical presentation, complications, and treatment of acute pancreatitis in children.
- To identify trends in pediatric acute pancreatitis diagnoses and outcomes.
Main Methods:
- Retrospective analysis of 57 children diagnosed with acute pancreatitis between 2019 and 2022.
- Data collected included patient history, causes, clinical symptoms, complications, and treatment strategies.
Main Results:
- Biliary (24.6%), genetic (17.5%), and anatomical defects (14%) were the most frequent causes of AP in children.
- Idiopathic AP accounted for 35.1% of cases.
- Common symptoms included abdominal pain, vomiting, and jaundice; complications like fluid collections and necrosis occurred in 15.8%.
Conclusions:
- The incidence of diagnosed pediatric acute pancreatitis is increasing.
- Genetic predispositions, infections, and gallstones are key etiological factors.
- AP should be suspected in children presenting with abdominal pain, vomiting, and jaundice, as severe complications can arise.
Abstract:
Acute pancreatitis (AP) is a multifactorial, complicated inflammatory process that involves the organ and the tissues around it. In children, the most common causes of acute pancreatitis are abdominal trauma, infections (mostly viruses), systemic diseases, bile duct diseases (anatomical defects and/or gallstones) and genetic mutations. The course of the disease can vary from mild to very severe with life-threatening complications. The aim of this study was to conduct a retrospective analysis of causes, clinical picture, complications and treatment of acute pancreatitis in children. Materials and methods: We retrospectively analyzed the history of 57 children hospitalized in the Department of Paediatrics, Medical University of Silesia in Katowice between 2019 and 2022 with diagnosed acute pancreatitis. Results: The analysis included 57 children (age 2-18 years, average 11.0 years, 51% boys, 49% girls) with diagnosed acute pancreatitis. The most common causes of acute pancreatitis were biliary (14/57-24.6%), genetic (10/57-17.5%) and anatomical defects (8/57-14%). In 20/57 (35.1%) children, idiopathic acute pancreatitis was diagnosed. The genetically determined causes were the following: SPINK1 mutation in 5/57 (8.7%) children, PRSS1 mutation in 4/57 (7%) patients and CPA1 mutation in 1/57 (1.8%) children. A total of 19/57 (33.3%) children had more than one episode of acute pancreatitis during the considered period. A total of 10/57 (17.5%) children were obese. The clinical picture was dominated by abdominal pain, vomiting and jaundice. Complications were observed in 9/57 (15.8%) children: peripancreatic fluid collections (6/57-10.5%), pancreatic necrosis (4/57-7%), and pleural effusion and/or pseudocysts. Conclusions: The number of children diagnosed and treated with acute pancreatitis increased over time. The most frequent causes are genetic predispositions, infections and cholelithiasis. Acute pancreatitis should be considered in every case of abdominal pain, vomiting and jaundice in children. Complications with a severe course are also observed in the pediatric population with acute pancreatitis.
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