Pediatric pancreatitis: Outcomes and current understanding

Abstract

Aim:The aim of this study was to analyze the clinical spectrum of pediatric pancreatitis and review current literature with regard to concepts of disease and management approaches.Materials and Methods:This is a retrospective analysis of pancreatitis patients admitted to a tertiary referral pediatric surgical unit from March 2013 to September 2018.Results:There were 106 patients from 1 year to 18 years with median age group between 11 and 15 years and equal gender distribution. Sixty-two children had acute pancreatitis (AP), with 13 of them having recurrent episodes. Forty-four patients had chronic pancreatitis (CP). Definite etiology was found in 11 AP patients. All patients had radiological changes. All AP patients were treated symptomatically except those with correctable underlying etiology. Sixteen with CP required intervention in the form of endoscopic retrograde cholangiopancreatography sphincterotomy/stenting or surgery. There were two mortalities. One with acute necrotizing pancreatitis and one CP girl due to the complication of diabetes mellitus, unrelated to episode of pancreatitis. All others are well at the last follow-up.Conclusion:Pediatric pancreatitis is a disease with a wide spectrum, but management can be standardized. Newer studies reveal that certain genetic mutations make children more susceptible to pancreatitis. Increasing incidence must prompt us to evaluate further so as to better equip ourselves to managing this disease entity in all its forms and evolve preventive strategies.

Demographics and risk factors for pediatric recurrent acute pancreatitis

“…In contrast, the report from India identified 62 individuals (13 were 16–18 years) with an even sex distribution and 21% having RAP and 71% having chronic pancreatitis. The high prevalence of chronic pancreatitis in this report is likely related to selection bias as it involved patients admitted to a tertiary referral pediatric surgery unit [4].…”

Acute pancreatitis in childhood – a comparative international study and tale of two cities

“…[21][22][23][24][25] Studies show that pancreatitis occurring in the paediatric population may be a disease with a wide indolent spectrum of severity and variable health outcomes. [25][26][27] The current study therefore aimed to critically analyse clinical presentation, individualized management and health related outcomes of acute pancreatitis (AP) in two distinct childhood cohort groups from two major paediatric surgical centres located in Bangkok Thailand and Liverpool, UK. The aetiology of acute pancreatitis in childhood may therefore have a very different course and spectrum to that seen in adult populations with gallstone disease here much less frequent and concurrent co-associated medical illness more prevalent.…”

“…Ethnicity has been convincingly shown as a predisposing factor in developing acute pancreatitis in childhood as well as being a major contributor that may also influence disease severity 21–25 . Studies show that pancreatitis occurring in the paediatric population may be a disease with a wide indolent spectrum of severity and variable health outcomes 25–27 . The current study therefore aimed to critically analyse clinical presentation, individualized management and health related outcomes of acute pancreatitis (AP) in two distinct childhood cohort groups from two major paediatric surgical centres located in Bangkok Thailand and Liverpool, UK.…”

Chronic pancreatitis in children: between gastroenterologist and surgeon

“…Более трети пациентов с хроническим панкреатитом требуют вмешательства из-за непреодолимой боли, приводящей к повторным госпитализациям. являются ЭРХПГ, сфинктеротомию, установка стента, процедура Puestow, процедура Frey [61]. Несмотря на то, что неинвазивные процедуры, такие как сфинктерэктомия и эндоскопическая ретроградная холангиопанкреатография, доступны, они не решают фундаментальную проблему дренажной недостаточности в поджелудочной железе, поэтому выполняются неоднократно, что требует повторных госпитализаций.…”