Paediatric acute pancreatitis: Clinical profile and natural history of collections

Lal, Sadhna; Venkatesh, Vybhav; Rana, Surinder Singh; Anushree, Neha; Bhatia, Anmol; Saxena, Akshay Kumar

doi:10.1016/j.pan.2020.03.007

Cited by 16 publications

(13 citation statements)

References 29 publications

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“…In line with the spectrum of pediatric AP causes available in the literature, the etiologies in our study were biliary, traumatic, drug-induced, systematic disease-associated, cystic fibrosis, pancreatic anomalies, and idiopathic [8,11,14]. Similar to findings by other studies [13,15], most of our cases of AP were attributed to biliary causes (n=23, 41.07%), consisting mostly of sickle cell disease-associated cholelithiasis (n=19, 33.9%).…”

Section: Discussionsupporting

confidence: 87%

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Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital

Hindi¹,

Khalaf²,

Nazzal³

et al. 2021

Cureus

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The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Study designWe retrospectively studied 56 patients who presented with AP to the pediatric department in Salmaniya Medical Complex between January 2006 and December 2017. Cases of chronic pancreatitis and ages above 12 years were excluded. The data concerned demographics, etiology, clinical data, hospital course, and outcomes. ResultsThe study included 56 patients aged a mean of 8.46 years (male:female -33:23). The average hospital stay was 7.68 days. Patients received parenteral feeds a mean of 2.77 days. All patients had an ultrasound, nine required CT scans (16.1%), and five MRIs (8.9%). There were 18 local complications (32.1%): pseudocysts (n=3, 5.36%), cholangitis (n=2, 3.6%), and edema (n=13, 23.2%). There were 23 intensive care unit (ICU) admissions (41.1%). No mortalities occurred but there were six recurrences (10.7%). Symptoms of abdominal pain, vomiting, fever, and nausea occurred in 100%, 57.1%, 35.7%, and 23.2% of patients, respectively. Etiologies were 41.1% biliary, 23.2% idiopathic, 19.6% traumatic, and 8.93% drug-induced. Leukocytes were elevated in 20 patients (35.7%), c-reactive protein (CRP) in five (8.93%), serum amylase in 45 (80.4%), and urinary amylase in all 56 patients (100%). ConclusionMost pediatric AP cases were attributed to biliary causes followed by trauma. Age was significantly correlated with complication rates (P=0.013). Abdominal pain was a more common symptom than vomiting. Leukocytosis was associated with ICU admissions. There was no significant relation between c-reactive protein, serum amylase, or urinary amylase, and complications or ICU admissions. Pediatric AP was selflimiting and there were no fatalities.

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Section: Discussionsupporting

confidence: 87%

“…We found that AP was more prevalent in males (58.9%), with a male to female ratio of 33:22. Similarly, Poddar et al and Lal et al found that AP was more common in males [10,14]. Furthermore, most patients were aged between six and 10 years old (69.6%).…”

Section: Discussionmentioning

confidence: 74%

Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital

Hindi¹,

Khalaf²,

Nazzal³

et al. 2021

Cureus

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“…After screening for eligibility, a total of 14 studies were included in this review. The included studies were published as full-text (10) or abstracts (4) between 2008 and 2021 [ 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ]. All the included studies were retrospective in nature.…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of fluid collection in 13 studies were pseudocysts in 108 (60.3%) and walled-off necrosis (WON) in 71 (39.7%). In one study, the proportions of pseudocysts and WON were not clearly defined [ 25 ]. The pooled mean PFC size was 11.5 cm (95% CI, 9.9–13.1 cm; I 2 =84.7%) ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Nabi

Talukdar

Lakhtakia

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Endoscopic drainage is an established treatment modality for adult patients with pancreatic fluid collections (PFCs). Available data regarding the efficacy and safety of endoscopic drainage in pediatric patients are limited. In this systematic review and meta-analysis, we aimed to analyze the outcomes of endoscopic drainage in children with PFCs. Methods A literature search was performed in Embase, PubMed, and Google Scholar for studies on the outcomes of endoscopic drainage with or without endoscopic ultrasonography (EUS) guidance in pediatric patients with PFCs from inception to May 2021. The study’s primary objective was clinical success, defined as resolution of PFCs. The secondary outcomes included technical success, adverse events, and recurrence rates. Results Fourteen studies (187 children, 70.3% male) were included in this review. The subtypes of fluid collection included pseudocysts (60.3%) and walled-off necrosis (39.7%). The pooled technical success rates in studies where drainage of PFCs were performed with and without EUS guidance were 95.3% (95% confidence interval [CI], 89.6–98%; I 2 =0) and 93.9% (95% CI, 82.6–98%; I 2 =0), respectively. The pooled clinical success after one and two endoscopic interventions were 88.7% (95% CI, 82.7–92.9%; I 2 =0) and 92.3% (95% CI, 87.4–95.4%; I 2 =0), respectively. The pooled rate of major adverse events was 6.3% (95% CI, 3.3–11.4%; I 2 =0). The pooled rate of recurrent PFCs after endoscopic drainage was 10.4% (95% CI, 6.1–17.1%; I 2 =0). Conclusion Endoscopic drainage is safe and effective in children with PFCs. However, future studies are required to compare endoscopic and EUS-guided drainage of PFCs in children.

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Acute Pancreatitis in Children

Templeton

Grover

2021

Curr Treat Options Peds

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Paediatric acute pancreatitis: Clinical profile and natural history of collections

Cited by 16 publications

References 29 publications

Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital

Acute Pancreatitis in Children: The Clinical Profile at a Tertiary Hospital

Outcomes of Endoscopic Drainage in Children with Pancreatic Fluid Collections: A Systematic Review and Meta-Analysis

Acute Pancreatitis in Children

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