Acute Pancreatitis in Children: Neither to be Underestimated Nor to be Overlooked

Abstract

Objective: Despite varying presentations of acute pancreatitis (AP) in children, the diagnosis has been increasing in recent years due to increased awareness. We aimed to identify the relationship among etiology, presentation symptoms, treatment response and complications of the children with acute pancreatitis. Material and Methods: Thirty children diagnosed with AP were evaluated for clinical and laboratory findings, treatment approaches, complications in the tertiary children hospital retrospectively. Results: The mean age of the patients was 12.4 ± 4.3 years and 60% were male. The drugs (30%), biliary tract diseases (26.7%), infections (16.7%), hyperlipidemia (10%) were the main causes of AP, in 10% of patients no etiological factor was detected. Abdominal pain (83.3%), nausea (70%), loss of appetite (63.3%), vomiting (56.7%), and fever (20%) were the most common symptoms. Ultrasonography, abdominal tomography and magnetic resonance cholangiopancreatography revealed pancreatitis related changes 63.3%, 85%, 70% of patients, respectively. Oral feeding was started on median 4 days (1-30), with polymeric diet (30%), and medium chain triglyceride rich enteral diet (70%). The median length of hospitalization (LOH) was 16.5 days (4-66). The patients fed with polymeric diet had a shorter hospitalization duration (p<0.036). The delayed initiation of oral feeding caused longer LOH (p<0.001). Conclusion: Consequently, this study underlines the children with acute abdominal pain, especially who use drugs like asparaginase and valproic acid, or that are known to have gallstone/biliary sludge, need to be examined for acute pancreatitis through pancreatic enzymes and ultrasonography. Moreover, the study also highlights that early feeding in acute pancreatitis is related with shorter hospitalization duration.