title: [Analysis of 13 critically ill children complicated with pancreatic damages].
abstract: OBJECTIVE
  To analyze the pathological reports and clinical data of the cases with pancreatic damage in critically ill children, and summarize the clinical features and biological markers of critically ill children with pancreatic damage or pancreatic necrosis so as to provide the basis for early diagnosis and treatment in children complicated with pancreatic damage.
  
  
  METHODS
  The clinical data of 13 patients treated in our hospital from 2003 to 2009 whose autopsy confirmed pancreatic damage existed and the pathological results of all organs were collected and analyzed.
  
  
  RESULTS
  All the cases had acute onset; 7 cases had fever, 2 had abdominal pain, the other cases had abdominal distention, hepatosplenomegaly, hypoactive bowel sounds, ascites, intestinal obstruction and gastrointestinal bleeding, etc. All these cases had abnormal liver function, especially elevated ALT or AST level and significantly decreased albumin, 9 cases had abnormal blood glucose, 5 cases had elevated C-reactive protein (CRP). In abdominal B-mode ultrasonography, no case showed abnormal pancreas acoustic image. Autopsy confirmed that 7 cases had varying degrees of necrosis of the pancreas, other 6 cases showed edematous, hemorrhagic or inflammatory changes, which may be associated with adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other damage. All these children died within 36 hours after the patients' conditions worsened.
  
  
  CONCLUSIONS
  Pancreatic damage or necrosis in critically ill children had acute and ferocious onset, short course and were prone to multiple organ damage or failure to which all pediatric clinicians should have high alert.
authors.affiliation: Department of Maternal and Child Health Care, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.forename: Yi-Min
authors.initials: YM
authors.lastname: Zhu
authors.forename: Wei-Jian
authors.initials: WJ
authors.lastname: Chen
authors.forename: Zhi-Yue
authors.initials: ZY
authors.lastname: Xu
authors.forename: Xiu-Lan
authors.initials: XL
authors.lastname: Lu
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: DU
mesh_terms: D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010179:Pancreas / Q000473:pathology*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies