Clinical characteristics of acute pancreatitis in children: a single-center experience in Western China

Abstract

Background: The diagnosis of pediatric pancreatitis has been increasing over the last 20 years. We aimed to compare the clinical characteristics for pediatric acute pancreatitis (AP) with adult AP, and investigate the risk factor for acute recurrent pancreatitis (ARP) in children. Method: From June 2013 to June 2019, a total of 130 pediatric patients with AP at the inpatient database were enrolled. Univariate analysis and multivariate Cox regression analysis were performed to identify the risk factors for ARP in children. Result: Major etiologic factors in 130 patients were biliary (31.5%), idiopathic (28.5%), trauma (16.2%). There was a significant difference in the constituent ratio of etiology between pediatric patients and adult patients (p<0.001). Compared with the adult patients, the pediatric patients had significantly lower severity (p=0.012) and occurrence rate of pancreatic necrosis (p=0.02). During the follow-up time (34.2±20.8 months), 19 children (14.6%) developed into ARP. Multivariate Cox regression analysis showed that female (p=0.025; OR=3.632; 95%confidence interval(CI) 1.179-11.188), hyperlipidemia (p=0.022; OR=3.480; 95%CI 1.201-10.085), pancreatic necrosis (p=0.001; OR=8.815; 95%CI 2.446-31.774) were the independent risk factors of ARP. The risk of recurrence was significantly different in each etiology group. Hyperlipidemic AP had the highest risk of recurrence over time, while viral and drug-induced AP had the lowest risk of recurrence (p=0.035).Conclusion: Biliary and idiopathic disease were the major etiologies of AP in children. Compared to adults, children tend to have milder disease conditions and a better prognosis. Female, hyperlipidemia, and first AP attack with pancreatic necrosis were associated with the increased risk of ARP.