Acute pancreatitis in children

Abstract

IntroductionThe acute pancreatitis is a rare disease, but it has started to be diagnosed more often in children.AimThe aim of the study was single-centre, retrospective analysis of the incidence, aetiology, and clinical course of acute pancreatitis in children.Material and methodsWe analysed the medical records of patients with acute pancreatitis hospitalised in the Gastroenterology Unit of the Paediatrics Department, Medical University of Silesia from Jan 2004 to Dec 2013.ResultsThere were 76 cases of acute pancreatitis among 51 children (average age: 12.07 years) hospitalised in the Gastroenterology Unit between January 2004 and December 2013. The diagnosis of acute pancreatitis was performed on the basis of INSPIRE criteria and modified Atlanta classification. Patients were divided into groups: I – 1–12 years old, which included 20 (39.21%) children and II – 13–18 years old, with 31 (60.78%) children. The idiopathic aetiology was the most common cause of acute pancreatitis, occurring in 22 (43.1%) children, and in 15 cases the aetiology of the disease was biliary (29.4%). Genetically determined causes were diagnosed in 8 (15.7%) patients, the PRSS1 mutation in four patients, mutation in SPINK1 in 1 child, and CFTR gene mutation in 1 child. Two children simultaneously had two genes mutations (CFTR, SPINK1), and during the considered period had more than one episode of acute pancreatitis.ConclusionsAcute pancreatitis of idiopathic aetiology was most common among the examined children, and this should encourage the continued search for the causes of disease, especially genetic, and with particular emphasis on younger age group.

Clinical characteristics of acute pancreatitis in children: a single-center experience in Western China

“…In addition, metabolic problems such as hyperlipidemia in children were signi cantly rarer than in adults. Only 2-7% of children with AP have metabolic causative factors [10,11]. In this study, 12 cases (9.2%) were caused by hyperlipidemia.…”

“…During the rst attack of AP in children, age, male sex, pancreatic necrosis, and higher Body Mass Index (BMI) have been associated with the progression of ARP. Anatomic abnormalities of the biliary tract, hyperlipidemia, and genetic factors should be evaluated in cases of recurrence [11,16,26]. In our study, among the 19 children (14.6%) with ARP, includes a 2-year-old toddler with congenital bile duct dilatation.…”

“…It has been reported [10][11][12] that the incidence of AP in children has shown an upward trend in recent years. The incidence rate in children in the United Kingdom was about 0.78/100 000 [13], while in the United States, this gure was 3-13/100 000 [3].…”

“…For AP with speci c causes, such as bile duct stones, anatomical abnormalities, bile duct dilatation, etc., it has been suggested that surgery should be performed as soon as possible after the condition is controlled and stable, to prevent recurrence [11,21]. In the literature [22], the mortality rate of pediatric AP is less than 5%, which is signi cantly lower than that of adult AP, possibly because: (1) Alcoholic pancreatitis is rare in pediatric cases, and alcoholic pancreatitis is a known cause of high mortality, with a mortality rate as high as 30.6% [23].…”

Pediatric Pancreatitis: Not a Rare Entity

“…On the other hand serum lipase levels have a sensitivity of 86.5-100% and specificity of 84.7-99.0%. In case of severe pancreatitis, serum lipase levels seven times higher than normal have been detected within the first 24 h. It is important to underline that in case of drug-induced acute pancreatitis serum amylase may not be elevate [9]. In addition, we may consider other chemistry panels to define a diagnosis like serum calcium, electrolytes, urea nitrogen, creatinine, transaminases, albumin, bilirubin, triglycerides and blood cell count [10].…”