Diagnosis and Management of Pancreatitis in Childhood: A Single-Centre Experience

Abstract

Background: Pancreatitis can be seen at any age in childhood. Therefore, it is important for pediatricians to know the diagnosis and the management of pancreatitis. Objectives: The aim of this study was to evaluate the etiological factors, clinical features and management of pancreatitis in children. Methods: This study included hospitalized children who were diagnosed with pancreatitis. The clinical presentations, laboratory analyses, radiological features, etiologies and treatments were recorded. Results: A total of 59 pancreatic attacks were recorded in 41 patients. The most common symptoms were abdominal pain and vomiting, and the most common etiological cause was idiopathic. Approximately 22% of the patients had acute recurrent episodes. Somatostatin was used to treat 61% of the attacks; however, it did not reduce the time to recovery after an attack when compared to those patients who did not use somatostatin (P = 0.36). The white blood cell counts and urea and calcium levels were significantly different between those patients who did and did not use somatostatin. Seventeen (28.8%) of the pancreatitis attacks were determined to be severe. Moreover, a mutation in the cystic fibrosis transmembrane conductance regulator was detected in two patients with recurrent pancreatitis. Conclusions: Fever and irritability can be signs of pancreatitis in infants and toddlers. In our cases, the somatostatin treatment was not effective in terms of the time to recovery after an attack.

Akut pankreatitli çocuklarda klinik özellikler, tanı, tedavi ve komplikasyonlar yönünden retrospektif analiz: tek merkez sonuçları

“…Although the etiology is investigated in the first step in patients who are diagnosed with pancreatitis, oral intake must be stopped to rest the pancreas, and fluid replacement therapy should be started to prevent complications. 11 In the study that was conducted by Appak et al 28 oral intake was discontinued in all patients at admission and opened within an average of four days.Similar to our study results, oral intake was opened in an average of three days. The mean time of switching to Diet 3 was determined as 7.06±5.03 days and oral intake was initially discontinued in 159 (95.78%) patients, and saline intravenous fluid containing sodium concentration appropriate for their age was administered.In a study conducted in our country, TPN was started in 32.2% of the patients for an average of 15.1±12.6 days.…”