Murat Çakır, Elif Bahat-Özdoğan, Mustafa İmamoğlu, Elif Sağ, Süleyman Caner Karahan, Gülay Kaya, Haluk Sarıhan

Acute pancreatitis in children: A single center experience over ten years

Acute pancreatitis (AP) is an inflammatory disease characterized by suddenonset abdominal pain together with elevation of pancreatic enzymes andradiographic changes. Increased incidence of AP in children have beenreported in recent reports. In this study; we aimed to analyze the demographiccharacteristics, etiology, outcome and incidence of AP among hospitalizedchildren in our center. Medical records of the children with AP sinceJanuary 2005 were analyzed from hospital files (N=63). Major etiologieswere systemic diseases (14.3%), trauma (11.1%), cholelithiasis (9.5%); 54%(N=34) of the patients had mild AP, while 28.6% (N=18) had moderatelysevere AP and 17.4% (N=11) had severe AP. Organ dysfunction was foundin 11 patients (17.4%) at initial examination. During the follow-up period(68.1±24.3 months), 10 patients (15.9%) experienced 24 recurring AP (RAP)attacks. Male gender, presence of local pancreatic or systemic complicationsat initial attack, metabolic and hereditary diseases were associated with theincreased risk of RAP (p

PDF

___

1. Suzuki M, Sai JK, Shimizu T. Acute pancreatitis in children and adolescents. World J Gastrointest Pathophysiol 2014; 5: 416-426.
2. Forsmark CE, Vege SS, Wilcox CM. Acute pancreatitis. N Engl J Med 2016; 375: 1972-1981.
3. Husain SZ, Srinath AI. What’s unique about acute pancreatitis in children: Risk factors, diagnosis and management? Nat Rev Gastroenterol Hepatol 2017; 14: 366-372.
4. Weizman Z, Durie PR. Acute pancreatitis in childhood. J Pediatr 1988; 113: 24-29.
5. Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: A systematic review. Pancreas 2006; 33: 323-330.
6. Park A, Latif SU, Shah AU, et al. Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis. J Pediatr Gastroenterol Nutr 2009; 49: 316-322.
7. Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A report of 320 cases of childhood pancreatitis: Increasing incidence, etiologic categorization, dynamics, severity assessment, and outcome. Pancreas 2017; 46: 110-115.
8. Pant C, Deshpande A, Olyaee M, et al. Epidemiology of acute pancreatitis in hospitalized children in the United States from 2000-2009. PLoS One 2014; 9: e95552.
9. Lopez MJ. The changing incidence of acute pancreatitis in children: a single-institution perspective. J Pediatr 2002; 140: 622-624.
10. Morinville VD, Husain SZ, Bai H, et al.; INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr 2012; 55: 261-265.
11. Abu-El-Haija M, Kumar S, Szabo F, et al.; NASPGHAN Pancreas Committee. Classification of acute pancreatitis in the pediatric population: Clinical report from the NASPGHAN Pancreas Committee. J Pediatr Gastroenterol Nutr 2017; 64: 984-990.
12. Pezzilli R, Morselli-Labate AM, Castellano E, et al. Acute pancreatitis in children. An Italian multicentre study. Dig Liver Dis 2002; 34: 343-348.
13. Majbar AA, Cusick E, Johnson P, Lynn RM, Hunt LP, Shield JP. Incidence and clinical associations of childhood acute pancreatitis. Pediatrics 2016; 138: e20161198.
14. Fayyaz Z, Cheema HA, Suleman H, Hashmi MA, Parkash A, Waheed N. Clinical presentation, aetiology and complications of pancreatitis in children. J Ayub Med Coll Abbottabad 2015; 27: 628-632.
15. Kandula L, Lowe ME. Etiology and outcome of acute pancreatitis in infants and toddlers. J Pediatr 2008; 152: 106-110.
16. Mekitarian Filho E, Carvalho WB, Silva FD. Acute pancreatitis in pediatrics: A systematic review of the literature. J Pediatr (Rio J) 2012; 88: 101-114.
17. Nydegger A, Heine RG, Ranuh R, Gegati-Levy R, Crameri J, Oliver MR. Changing incidence of acute pancreatitis: 10-year experience at the Royal Children’s Hospital, Melbourne. J Gastroenterol Hepatol 2007; 22: 1313-1316.
18. Grodinsky S, Telmesani A, Robson WL, Fick G, Scott RB. Gastrointestinal manifestations of hemolytic uremic syndrome: Recognition of pancreatitis. J Pediatr Gastroenterol Nutr 1990; 11: 518-524.
19. Pant C, Sferra TJ, Lee BR, Cocjin JT, Olyaee M. Acute recurrent pancreatitis in children: A study from the pediatric health information system. J Pediatr Gastroenterol Nutr 2016; 62: 450-452.
20. Hao F, Guo H, Luo Q, Guo C. Disease progression of acute pancreatitis in pediatric patients. J Surg Res 2016; 202: 422-427.
21. Lucidi V, Alghisi F, Dall’Oglio L, et al. The etiology of acute recurrent pancreatitis in children: A challenge for pediatricians. Pancreas 2011; 40: 517-521.
22. Su WJ, Chen HL, Lai HS, Ni YH, Chang MH. Pancreaticobiliary anomalies is the leading cause of childhood recurrent pancreatitis. J Formos Med Assoc 2007; 106: 119-125.
23. Lautz TB, Chin AC, Radhakrishnan J. Acute pancreatitis in children: Spectrum of disease and predictors of severity. J Pediatr Surg 2011; 46: 1144-1149.
24. Werlin SL, Kugathasan S, Frautschy BC. Pancreatitis in children. J Pediatr Gastroenterol Nutr 2003; 37: 591-595.
25. Goday PS, Wakeham M, Kuhn EM, Collins MM, Werlin SL. Acute pancreatitis in the pediatric intensive care unit. J Pediatr Gastroenterol Nutr 2015; 61: 108-112.
26. Guo Q, Li M, Chen Y, Hu H, Hu W. Predictors for mortality following acute pancreatitis in children. Pediatr Surg Int 2014; 30: 1111-1115.