Pancreaticobiliary anomalies is the leading cause of childhood recurrent pancreatitis.
OBJECTIVE
To explore the etiology, age and gender distribution, complications, and prognosis of recurrent pediatric pancreatitis.


METHODS
Between 1993 and 2005, 92 children were hospitalized at the National Taiwan University Hospital with pancreatitis. Only 25 diagnosed with recurrent pancreatitis, based on two or more episodes of pancreatitis, elevated serum amylase and/or lipase levels > or = 3 times the upper limit of normal, radiographic evidence, and clinical symptoms, were enrolled.


RESULTS
A total of 85 episodes of pancreatitis in 25 patients (16 girls, 9 boys; mean age, 9.5 +/- 4.4 years; 3.4 +/- 1.9 episodes per person) were documented. The recurrence rate of pediatric pancreatitis was 27.2%. Recurrent pancreatitis was associated with pancreaticobiliary structural anomalies (n = 7), biliary stones or sludge (n = 4), hyperlipidemia (n = 3), pseudopapillary tumor of the pancreas (n = 2), trauma (n = 2), hypoxic encephalopathy with recurrent bacteremia and sepsis (n = 1), and idiopathic (n = 6). The age and gender distribution according to etiologies were not different (p = 0.301 for age, p = 0.137 for gender). Complications included cholangitis or cholestasis (16%), pancreatic necrosis (16%), pseudocyst formation (12%), shock (8%), hemorrhagic pancreatitis (4%), and diabetes mellitus (4%). No patient died of recurrent pancreatitis. Long-term morbidity after recurrent pancreatitis presented as gout, diabetes mellitus, non-alcoholic steatohepatitis, and chronic pancreatitis.


CONCLUSIONS
For children who suffer from recurrent pancreatitis, pancreaticobiliary structural anomalies should be considered first.
Su
Wei-Ju
WJ
Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Chen
Huey-Ling
HL
Lai
Hong-Shiee
HS
Ni
Yen-Hsuan
YH
Chang
Mei-Hwei
MH
D000465:Algorithms; D001659:Biliary Tract / Q000002:abnormalities*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000002:abnormalities*; D010195:Pancreatitis / Q000453:epidemiology*; D012008:Recurrence; D013624:Taiwan / Q000453:epidemiology