Clinicopathologic studies in childhood pancreatitis.
In a review of pediatric autopsies from 1951 to 1985, we identified 40 cases in which pancreatitis was diagnosed pathologically. Twenty-six of these patients were under 4 years of age, and the male-to-female ratio was 1.5. Six groups of patients were identified: 10 with hepatobiliary disease, including 9 with biliary atresia; 7 with immunosuppressive therapy for tumors (n = 2), leukemia (n = 4) and aplastic anemia (n = 1); 6 with viral infections; 8 with congenital anomalies, including congenital heart disease (n = 3); and 9 with miscellaneous problems. Several patients had surgery and various intercurrent complications. Clinical features attributable to the pancreatitis included vomiting or excessive nasogastric drainage (60%), pleural effusions (40%), and abdominal pain (25%). However, the diagnosis was suspected clinically in only 5 of 40 patients. Our findings suggest several pathogenic mechanisms exist for childhood pancreatitis: biliary obstruction, infections, drug toxicity, immunosuppression (acting in synergy with drug toxicity, trauma, and low-flow states resulting from shock, heart failure, and vasculopathy.
Nguyen
T
T
Institute of Pathology, University Hospitals of Cleveland, Ohio.
Abramowsky
C
C
Ashenburg
C
C
Rothstein
F
F
D000293:Adolescent; D000741:Anemia, Aplastic / Q000150:complications; D001660:Biliary Tract Diseases / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D005313:Fetal Death / Q000473:pathology; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010195:Pancreatitis / Q000209:etiology / Q000473:pathology*; D011247:Pregnancy; D012189:Retrospective Studies; D014777:Virus Diseases / Q000150:complications