Title: Acute pancreatitis, differences in childhood
- Mirosława Uścinowicz, Maciej Kaczmarski
- Original articles
- Polish Gastroenterology
- Start page:
- Final page:
- acute pancreatitis, children
Introduction: The main causes of acute pancreatitis (AP) in childhood are gallstones and structural pancreatobiliary disorders, but often abdominal trauma, infections or systemic illness may be causative factors. The management of AP should be multidisciplinary. Aim of study: The aim of the study was to analyse of the causes, course of disease, diagnostictests and therapeutic methods in children with AP, and to compare them with respect to AP in adult hood.
Material and methods: We analysed the illness history of 25 children with AP.The diagnosis was based upon clinical symptoms, positive laboratory test and radiological imaging. The course of disease and methods of treatment are reviewed and discussed.
Results: The main causes of AP in study group were gallstone disease and abnormality of pancreatobiliary tract (36%), others were: nutritional factors (16%), infections (12%), metabolic disorders (8%), genetic background (8%), drugs (4%), trauma (4%); in 12% AP was idiopathic. Rare cases such as duodenal cyst, hereditary pancreatitis and cystic fibrosis are discussed. Ali children fulfilled biochemical criteria of AP (elevated serum amylaseandlipase), but laboratorymarkersofinflammation were normalin 20%. Abdominal ultrasonography was mandatory at diagnosis in all, computed tomography was necessary in severe AP, other radiological techniques were used in complicated cases. Severe course of AP was diagnosed in 16%, in others AP was mild. Treatment was primarily supportive, surgery was necessary in patients with gallstones. Conclusions: We emphasised differences in causes of AP in childhood, but diagnosis and therapy is similar in comparison with adulthood. Proper management and altering the natural history of AP may prevent chronic pancreatitis.