Acute pancreatitis in children

Chang, Yi-Jung; Chao, Hsun‐Chin; Kong, Man‐Shan; Hsia, Shao‐Hsuan; Lai, Ming‐Wei; Yan, Dah‐Chin

doi:10.1111/j.1651-2227.2011.02158.x

Cited by 46 publications

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“…The results of this pediatric sample show that pancreatitis can have multiple and complex etiologies in children. Among the diverse range of etiologies of pediatric AP, gallstones and biliary disease seem to play a greater role than previously thought [1,2,10,11,[19][20][21]. In this report, it was also the most common (24.3%) etiological cause.…”

Section: Resultsmentioning

confidence: 53%

Acute pancreatitis in children: a tertiary hospital report

Antunes

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Mesquita

et al. 2014

Scandinavian Journal of Gastroenterology

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Introduction. The incidence of acute pancreatitis (AP) in children has increased significantly in the past two decades. Objective. All cases of AP, acute recurrent pancreatitis (ARP), and chronic pancreatitis examined between May 2002 and May 2012 at Hospital de Braga, Portugal, were reviewed. Material and methods. Patients were identified by searching the hospital's electronic discharge records for the International Classification of Disease, Ninth Revision (ICD-9) code 577.0 (acute pancreatitis). ARP was considered as two or more episodes of AP per year or more than three episodes over a lifetime with intervening return to baseline. The following data were analyzed: demographic information, clinical, laboratory and imaging test results, etiology of pancreatitis, medical and surgical management, length of hospitalization, and outcome. The clinical and laboratory factors used in the pediatric acute pancreatitis severity score system and computed tomography severity index (CTSI) score were compared between patients with mild and severe disease. Results. A total of 37 patients, 31 episodes of AP and 6 patients with ARP, were documented. The most prevalent etiologies were biliary stones/sludge (24.3%) and trauma (16.2%). Admission elevated white blood cell count (p = 0.011), 48-h trough calcium (p = 0.007), and 48-h rise in blood urea nitrogen (p = 0.025) correlated significantly with disease severity. CTSI on admission had a score below 4 in three patients with severe disease. Conclusion. This Portuguese pediatric pancreatitis report highlights the multiple and complex etiology of this disease. Better pediatric scoring systems and management algorithms are needed.

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Section: Resultsmentioning

confidence: 53%

Acute pancreatitis in children: a tertiary hospital report

Antunes

Nascimento

Mesquita

et al. 2014

Scandinavian Journal of Gastroenterology

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“…De maneira semelhante ao que ocorre em adultos, as doenças do trato biliar, sejam representadas por cálculos biliares, barro biliar ou anomalias anatômicas do pâncreas e seu sistema ductal (como anomalias do esfíncter de Oddi ou pancreas divisum) são importantes causas de PA, podendo corresponder de 10 a 30% dos casos 3,4 ; entretanto, em estudos de coorte retrospectivo, a incidência de PA biliar pode ser mais alta, chegando a 50% 9 . O barro biliar (excesso de resíduos de sais biliares na vesícula biliar) pode representar até 30% dos casos de obstrução biliar em crianças, diferentemente de adultos cuja obstrução é quase exclusivamente devida à litíase biliar ou tumores com características compressivas.…”

Section: Pancreatite Aguda Biliarunclassified

Acute pancreatitis in pediatrics: a systematic review of the literature

2012

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Objective: To describe the main epidemiological, clinical, diagnostic and treatment aspects of children with acute pancreatitis.Sources: Systematic review of MEDLINE and SciELO databases in the last 5 years on acute pancreatitis in children, as well as consultation of relevant references on the texts obtained. Summary of the findings:Cases of acute pancreatitis in children have received growing attention in recent years, and an increase in the number of cases has been reported in several studies. The main etiologies in children involve biliary disease, drug-induced pancreatitis, recurrent hereditary pancreatitis and trauma, and up to 30% of cases have no defined etiology. The diagnosis is based on the combination of clinical and laboratory aspects with the increase of acinar enzymes and radiologic tests. Initial support treatment, with proper volume replacement and correction of the metabolic disturbances, besides specific nutritional therapy, are the fundamental points in the handling of acute conditions. Long term complications are unusual, and mortality rates are inferior to the rates for the adult population. Conclusions:The early diagnosis and the appropriate handling can contribute to a better outcome for the child with pancreatitis and to prevent the immediate and late complications related to the disease. More studies are required to better explain aspects related to the clinical and radiological diagnosis of pancreatitis in children, as well as aspects related to the nutritional therapy for this age group. J Pediatr (Rio J). 2012;88(2):101-14: Pancreatitis, pediatrics, nutritional support, morbidity, enteral nutrition. ResumoObjetivo: Descrever os principais aspectos epidemiológicos, clínicos, diagnósticos e do tratamento de crianças com pancreatite aguda. Fontes dos dados:Realizada revisão sistemática das bases de dados MEDLINE e SciELO nos últimos 5 anos sobre pancreatite aguda em crianças, bem como consultadas referências relevantes dos textos obtidos. Síntese dos dados:Os casos de pancreatite aguda em crianças recebem crescente atenção nos últimos anos, sendo verificado um aumento na incidência da doença em diversos estudos. As principais etiologias em crianças envolvem doença biliar, pancreatite secundária a medicamentos, pancreatite hereditária recorrente e trauma, sendo até 30% dos casos sem etiologia definida. O diagnóstico baseia-se na combinação de aspectos clínicos, laboratoriais com elevação das enzimas acinares e testes radiológicos. Tratamento de suporte inicial, com reposição volêmica adequada e correção dos distúrbios metabólicos, além de terapêutica nutricional específica, são os pontos fundamentais no manejo dos quadros agudos. Complicações a longo prazo são incomuns, e as taxas de mortalidade, inferiores às da população adulta. Conclusões:O diagnóstico precoce e o manejo apropriado podem contribuir para a melhor evolução da criança com pancreatite e prevenir as complicações imediatas e tardias relacionadas à doença. Mais estudos são necessários para melhor elucidar aspectos re...

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“…AP has been associated with systemic diseases in 2-53% cases in paediatric series. 2,[4][5][6]21,23,24,26,29 This variation may be partly due to differences in the definition of AP and age of patients and to the variations in classification and assigning the associated agents. The changing incidence in Australia was attributed in part to an increase in cases associated with systemic illnesses.…”

Section: Discussionmentioning

confidence: 99%

“…In total, 5% of our cases were attributed to anatomical congenital anomalies (pancreas divisum and choledochal cyst); which is similar to the 5% reported in America, 24 but much lower than the 23% and 43% reported in Taiwan and Japan. 21,27 Anatomical anomalies, particularly choledochal cyst, are known to be more common in Asian than in Western children. 27 Two cases in our study were associated with systemic diseases, namely systemic lupus erythematosus and Henoch Schonlein purpura.…”

Section: Discussionmentioning

confidence: 99%

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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Acute pancreatitis in children

Abstract: Acute pancreatitis in children is associated with significant morbidity and mortality. The severity of paediatric pancreatitis may be influenced by aetiology. CT is recommended for evaluation of severity of pancreatitis.

Cited by 46 publications

References 27 publications

Acute pancreatitis in children: a tertiary hospital report

Acute pancreatitis in children: a tertiary hospital report

Acute pancreatitis in pediatrics: a systematic review of the literature

Incidence and Clinical Associations of Childhood Acute Pancreatitis

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