Pancreatitis in children--experience with 43 cases.
Pancreatitis in children is not common and can be associated with severe morbidity and mortality. We encountered 43 children, ranging in age from 2 to 18 years, with pancreatitis over the past 10 years. The diagnosis of pancreatitis was made in those patients who showed: (1) significant intra-operative pathology or; (2) clinical findings of pancreatic inflammation and laboratory confirmation. More than one third (16 cases) of the cases were due to trauma, other causes included systemic disease (10), structural disease (8), and toxins or drugs (4). Five cases were classified as idiopathic. Most of the patients presented with abdominal pain (95%) and vomiting (56%). Jaundice was found in 7 patients and an abdominal mass in 2. Morbidity included pseudocyst (10), relapse (4), hyperglycaemia (4) and miscellaneous problems. Eight (50%) of the patients with trauma and 6 (86%) of the patients with structural diseases required surgery. Other patients were managed conservatively with bowel rest, gastric decompression, intravenous fluid and total parenteral nutrition. One case had a fatal outcome. All the survivors did well in long term follow up. Relevant literature has been reviewed and the sensitivity of various diagnostic modalities compared and discussed. A lesser known association between pancreatitis and structural anomalies such as choledochal cyst is discussed. To our knowledge, the present review is the first on pancreatitis in Chinese children.


CONCLUSIONS
Pancreatitis can occur from a wide variety of causes and may result in severe complications. Early diagnosis, close monitoring and aggressive intervention are mandatory to reduce morbidity and mortality.
Yeung
C Y
CY
Department of Paediatrics, Mackay Memorial Hospital, Taipei Taiwan, ROC.
Lee
H C
HC
Huang
F Y
FY
Ho
M Y
MY
Kao
H A
HA
Liang
D C
DC
Hsu
C H
CH
Hung
H Y
HY
Chang
P Y
PY
Sheu
J C
JC
D000006:Abdomen, Acute / Q000209:etiology; D000293:Adolescent; D000681:Amylases / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003401:Creatine / Q000097:blood; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010179:Pancreas / Q000473:pathology; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D015996:Survival Rate
D000681:Amylases; D003401:Creatine