Acute pancreatitis in children: A retrospective analysis of 133 patients

ABSTRACT Aim: Acute pancreatitis (AP) is the most common pancreatic disease in children and its frequency has been increasing in recent years. In our study, we aimed to evaluate the management of the disease in children with acute pancreatitis. Methods: In this study, 133 patients with acute pancreatitis in Ondokuz Mayıs University Faculty of Medicine Children's Hospital Pediatric Gastroenterology clinic between 2010-2022 were analyzed. Demographic characteristics, presenting symptoms, laboratory tests, imaging methods, etiological causes, severity of disease, prognosis, treatment methods, hospitalization and intensive care needs of the patients were evaluated retrospectively. Results: A total of 133 patients, 62 (45,9%) female and 72 (54,1%) male were included in our study and the mean age was 11,24,8 years. The most common etiology of acute pancreatitis was obstructive causes (30,8%), followed by idiopathic (29,3%), drug-induced (15%), trauma (9,8%), infection (6,8%), chronic disease (6%) pancreatitis due to metabolic disease (1,5%). Abdominal pain (88,7%) and nausea/vomiting (77.4%) were the most common presenting symptoms. Fever was present in 14,3% of the patients. The levels of amylase in 83% of the patients, and lipase in 82% of the patients were three times higher than normal, mean enzyme levels were 918991 IU/L for amylase and 22253293 IU/L for lipase. In laboratory tests obtained at the time of admission to the hospital, the mean white blood cell was 111425550 /mm3, and it was higher than normal in 46% of the patients. The mean CRP values were 38,572,8 mg/L and was higher than normal in 66% of the patients. The mean values of albumin, calcium, LDH and BUN were 4,230,56 gr/dL, 9,630,56 mg/dL, 301182 U/L ve 11,9510,48 mg/dL, respectively. The mean time of healing clinically and oral nutrition initiation was 3,953,29 days, and the return to normal of laboratory parameters was 10,7411,73 days. Antibiotherapy was used in 123 (92.5%) of the patients. Somatostatin analog (octreotide) was given to 48.9% of the patients, and the mean of administration was 7.3 days. The mean hospitalization was 9,538,58 days, 4 patients (3%) were followed up in the intensive care unit. The most common complication was secondary infection/sepsis with a rate of 17,3%, and pseudocyst (8,3%) was the second most frequent complication. Recurrent pancreatitis were seen in 12% of our patients. Conclusion: The most important causes of childhood pancreatitis are biliary obstructive pathologies, drugs, systemic diseases and trauma. Especially in severe AP patients, it is possible to prevent serious complications with close clinically monitoring and appropriate therapeutic management. Key words: Acute pancreatitis, childhood, recurrent pancreatitis, etiology, pseudocy