Acute pancreatitis in children: A 15-year review

Haddock, Graham; Coupar, Graeme; Youngson, George; MacKinlay, Gordon A.; Raine, P.A.M.

doi:10.1016/0022-3468(94)90353-0

Cited by 61 publications

(52 citation statements)

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“…2,24,25 Asparaginase-associated pancreatitis has been reported in 6.7-18% of cases following leukaemia treatment in children, 33 but the risk was only 1.5% in children and young adults with acute lymphoblastic leukaemia in the UK. 34 Gallstones were the second most frequent association, accounting for 13% of the total patients, compared to 4% in a previous study in Scotland, 13 and no cases in other UK series. 8,12 Gallstones were not exclusively associated with the overweight or haemolytic diseases, as 5 out of 12 cases had no recognised risk factors.…”

Section: Discussionmentioning

confidence: 56%

“…Despite recent advances in diagnostic techniques, including pancreatico-biliary imaging and genetic testing, we found a high proportion of idiopathic AP in UK children although this was within previously reported national ranges of 25-56%. 8,12,13 Idiopathic AP seems to be more common in children. It has been reported globally in a wide range of proportions in children, from 15 to 36% of total cases.…”

Section: Discussionmentioning

confidence: 99%

“…2,11 Trauma and mumps were the commonest associations reported in the UK in the 1970/80's. 8,12,13 However, there has been no effort to re-examine the associated agents of this disease in the UK in the last three decades. The last study conducted within the UK was performed in Scotland in the 1990s on retrospective data from 1978-1992, where mumps (39%) and trauma (14%) were the most frequent associations.…”

Section: Introductionmentioning

confidence: 99%

“…The last study conducted within the UK was performed in Scotland in the 1990s on retrospective data from 1978-1992, where mumps (39%) and trauma (14%) were the most frequent associations. 13 Several changes in population characteristics, including the introduction of the MMR vaccine in 1988 and an increase in the prevalence of obesity-associated gallstones among children, 14 may have changed the incidence and causative agents responsible for this relatively rare condition in childhood. Therefore, the aims of this study were to conduct the first prospective examination of the incidence of AP in UK children and to determine its current clinical associations.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and Clinical Associations of Childhood Acute Pancreatitis

et al. 2016

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. Conflict of Interest:The authors have no conflicts of interest relevant to this article to disclose. What's Known on This Subject: Acute pancreatitis in childhood is a relatively rare but potentially serious condition. In the past, trauma and mumps have been the commonest associations. No study has ever estimated incidence within a childhood population on a prospective basis. AbbreviationsWhat This Study Adds: Acute pancreatitis has a childhood incidence in the UK of 0.78 per 100,000/year (95%CI 0.62-0.96). Gallstones and drug therapy are now the most commonly identified associations whilst mumps and trauma are identified rarely. Children of Pakistani heritage are disproportionately affected. Contributors' Statements:Abdalmonem Majbar: Dr Majbar helped with designing the data collection instruments, collected the data, conducted all analyses, drafted the initial manuscript, and approved the final manuscript as submitted.Eleri Cusick and Paul Johnson: Ms Cusick and Professor Johnson contributed to study conceptualization and design, took part in data interpretation, critically reviewed the manuscript, and approved the final manuscript as submitted.Richard Lynn: Mr Lynn contributed to study conceptualization and design, critically reviewed the manuscript, and approved the final manuscript as submitted.Linda Hunt: Dr Hunt supported and contributed to the statistical analysis, critically reviewed the manuscript, and approved the final manuscript as submitted.Julian Shield: Professor Shield conceptualized and designed the study, supervised and assisted data collection and analyses, critically reviewed the manuscript, and approved the final manuscript as submitted.All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Results: 94 cases (48 boys) fulfilled the diagnostic criteria. The median age at diagnosis was 11.2 years (range 1.3-14.9). White children accounted for 61% of the cases compared to 28% from Asian and 5% from African ethnicities. Pakistani children accounted for 18 of 26 (69%) Asian patients and 19% of the total cohort. The incidence of AP in children in the UK was 0.78 per 100,000/year (95%CI 0.62-0.96). The incidence in Pakistani children (4.55; 95%CI 2.60-7.39) was 7-fold greater than White children (0.63; 95%CI 0.47-0.83). Of the 94 cases: 35 (37%) were idiopathic or associated with drugs 18 (19%), gallstones 12 (13%), hereditary 7 (7%), organic acidaemias 7 (7%), anatomical anomalies 5 (5%), viral infections 3 (3%), systemic diseases 2 (2%) and trauma 1 (1%). The most common drug associations were asparaginase (28%), azathioprine (17%) and sodium valproate (17%). Conclusions:Whilst still relatively uncommon in the U...

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incidence and Clinical Associations of Childhood Acute Pancreatitis

et al. 2016

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“…In a considerable proportion of up to 25% of the patients, no aetiological factor is identified and is therefore labeled as idiopathic (Haddock et al, 1994;Uretsky et al, 1999;Mehta & Gittes, 2005;Hebra et al, 2009;Werlin, 2003).…”

Section: Acute Pancreatitismentioning

confidence: 99%

Childhood Pancreatitis

Ali¹

2012

Pancreatitis - Treatment and Complications

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Surgical Therapy and Follow‐up of Pancreatitis in Children

Petersen,

Goetz,

Bürger

et al. 1997

J. pediatr. gastroenterol. nutr.

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BackgroundAcute and chronic pancreatitis in children differ from that in adults both from the etiology and the therapeutic approach. Within the frame of a blunt abdominal trauma‐the most frequent cause in children‐acute pancreatitis is often detected by emergency laparotomy and external drainage is recommended. Chronic relapsing pancreatitis, and particularly its hereditary form, is very rare in children and requires a different therapeutic concept. The results of surgical therapy for both forms of pancreatitis in childhood were evaluated in the present study.MethodsSixteen patients with acute and chronic relapsing pancreatitis were operated on in our facility between 1976 and 1988. Their history and postoperative course were analyzed in a retrospective study, including a final examination at the end of the follow‐up period.ResultsEight children with acute pancreatitis were operated on at an average age of 6 years and were followed up for an average of 7.5 years, with good results. The remaining children, aged between 3 and 14 years (average age of 9 years), were operated on for chronic relapsing pancreatitis. Our experience with early operative treatment, on average 2.7 years after onset of symptoms, is presented. Only three patients experienced a mild relapse during the follow‐up period of 2‐13 years (average of 5.4 years).ConclusionsFor acute pancreatitis in childhood, operative treatment by inner drainage is necessary and effective only in case of complications, should conservative treatment fail. In children with chronic relapsing pancreatitis, the good exocrine and the normal endocrine function of the pancreas in these patients justified the early operation. Timely treatment is recommended in cases with typical changes of the pancreatic duct so as to shorten the relapsing clinical problems of the children and to maintain the function of the pancreas.

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Acute pancreatitis in children: A 15-year review

Cited by 61 publications

References 10 publications

Incidence and Clinical Associations of Childhood Acute Pancreatitis

Incidence and Clinical Associations of Childhood Acute Pancreatitis

Childhood Pancreatitis

Surgical Therapy and Follow‐up of Pancreatitis in Children

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