Chronic pancreatitis in Chinese children: etiology, clinical presentation and imaging diagnosis.
OBJECTIVE
There is a paucity of literature regarding the clinical profile of chronic pancreatitis (CP) in children. The aims of this retrospective study were to determine the etiology and clinical presentation, and to present our experience in diagnosing CP in children in China.


METHODS
Clinical data of children who were treated for CP at Changhai Hospital from January 1997 to August 2006 were reviewed.


RESULTS
A total of 427 CP patients presented to our center. There were 42 (9.8%) children with CP, including 21 males and 21 females, with a mean age of 11.7 years at the first onset. The main etiological factor was idiopathic (73.8%). Of the patients, 78.5% had episodes of mild to moderate abdominal pain and 54.8% had multiple (> or = 4) episodes. The mean duration of symptoms prior to the diagnosis was 41.6 months and a definite diagnosis was not made until 2 years later in 57.1% of these patients. The positive rates of ultrasound (US), computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) (or magnetic resonance imaging [MRI]) for detecting ductal changes and intraductal stones or pancreatic calcification were 51.4% and 45.4%, 71.4% and 87.5%, 80.0% and 61.5%, respectively.


CONCLUSIONS
The main etiological factor of Chinese children with CP is idiopathic. The main symptom in these patients is multiple episodes of mild to moderate abdominal pain, which often lead to a delay in the definite diagnosis. CT and MRCP (or MRI) should be used as the first investigation in the evaluation of these cases.
Wang
Wei
W
Chronic Pancreatitis Study Group, Department of Gastroenterology, Changhai Hospital, The Second Military Medicine University, Shanghai, China.
Liao
Zhuan
Z
Li
Zhao-Shen
ZS
Shi
Xin-Gang
XG
Wang
Luo-Wei
LW
Liu
Feng
F
Wu
Ren-Pei
RP
Zheng
Jian-Ming
JM
D015746:Abdominal Pain / Q000208:ethnology / Q000209:etiology; D000293:Adolescent; D017668:Age of Onset; D044466:Asian People; D002648:Child; D002681:China / Q000453:epidemiology; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed