Research Article
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Retrospective analysis of clinical characteristics, diagnosis, treatment and complications of children with acute pancreatitis: single-center results

Year 2023, Volume: 4 Issue: 5, 456 - 465, 27.10.2023
https://doi.org/10.47582/jompac.1341423

Abstract

Aim: In the present study, the purpose was to evaluate the demographic and clinical data of pediatric patients, who had pancreatitis, who were followed up as outpatients or in the wards, and to evaluate the treatment modalities used along with nutritional status, length of hospital stays, and complications.
Methods: This study was carried out by retrospectively evaluating the files of 166 patients identified by INSPPIRE Criteria who were followed up at the Department of Pediatric Gastroenterology, Faculty of Medicine, at xx University between 2011 and 2021. The age, gender, height, weight, known disease, drugs used, follow-up periods by us, complaints on admission, the etiological reason for the diagnosis, type of pancreatitis, length of hospital stay, treatment modalities applied, and complications of the patients were recorded. The PAPPS Scores, Ranson Admission Scores, and Ranson 48th hour Scores of the patients were analyzed.
Results: A total of 120 patients (72.3%) had AP, 25 patients (15.1%) had CP, and 21 patient (12.7%) had ARP. According to the Atlanta Criteria, 82.5% were mild and 17.5% were moderate. The most common complaint was abdominal pain and the most common cause was found to be idiopathic. There was a weak and positive correlation between the PAPPS Score, Ranson Admission Score, and length of hospital stay.
Conclusion: In the diagnosis and follow-up of pancreatitis, it is important to determine the severity of the disease and to reveal the etiology. Establishing and applying standard approaches for early diagnosis and treatment of patients will lead to prognostic improvement and prevent related complications.

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References

  • Pandol SJ, Forsmark CE. Consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer: achievements and future directions. Curr Opin Gastroenterol. 2021;37(5):486-490. doi: 10.1097/MPA.0000000000001167
  • Srinath AI, Lowe ME. Pediatric pancreatitis. Pediatr Rev. 2013;34(2):79-90. doi: 10.1542/pir.34-2-79
  • Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2018;16(3):175-184. doi: 10.1038/s41575-018-0087-5
  • Nydegger A, Heine RG, Ranuh R, Gegati-Levy R, Crameri J, Oliver MR. Changing incidence of acute pancreatitis: 10-year experience at the Royal Children’s Hospital, Melbourne. J Gastroenterol Hepatol. 2007;22(8):1313-1316. doi: 10.1111/j.1440-1746.2007.04936.x
  • Chang YJ, Chao HC, Kong MS, Hsia SH, Lai MW, Yan DC. Acute pancreatitis in children. Acta Paediatr. 2011;100(5):740-744. doi: 10.1111/j.1651-2227.2011.02158.x
  • Morinville VD, Husain SZ, Bai H, et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012;55(3):261-265. doi: 10.1097/MPG.0b013e31824f1516
  • Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A report of 320 cases of childhood pancreatitis: increasing incidence, etiologic categorization, dynamics, severity assessment, and outcome. Pancreas. 2017;46(1):110-115. doi: 10.1097/MPA.0000000000000733
  • Sweeny KF, Lin TK, Nathan JD, et al.Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 2019;68(1):104-109. doi: 10.1097/MPG.0000000000002145
  • DeBanto JR, Goday PS, Pedroso MRA, et al. Acute pancreatitis in children. Am J Gastroenterol. 2002;97(7):1726-1731. doi: 10.1111/j.1572-0241.2002.05833.x
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi: 10.1136/gutjnl-2012-302779
  • Lee PJ, Papachristou GI. New insights into acute pancreatitis. Nature reviews. Gastroenterol Hepatol. 2019;16(8):479-96. doi: 10.1038/s41575-019-0158-2
  • Basit H, Ruan GJ, Mukherjee S. Ranson criteria. 2018. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Bookshelf ID: NBK482345
  • Li Y, Dillman JR, Anton CG, et al. Secretin Improves Visualization of Nondilated Pancreatic Ducts in Children Undergoing MRCP. AJR Am J gastroentgenol. 2020;214(4):917-922. doi: 10.2214/AJR. 19.21798
  • Uc A, Fishman DS. Pancreatic Disorders. Pediatr Clin North Am. 2017;64(3): 685-706. doi: 10.1016/j.pcl.2017.01.010
  • Werlin SL, Kugathasan S FB. Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003;37(5):591-595. doi: 10.1097/00005176-200311000-00017
  • Fonseca Sepúlveda EV, Guerrero-Lozano R. Acute pancreatitis and recurrent acute pancreatitis: an exploration of clinical and etiologic factors and outcomes. Jornal de Pediatria. 2019;95(6):713-719. doi: 10.1016/j.jped.2018.06.011
  • Park AJ, Latif SU, Ahmad MU, et al. A comparison of presentation and management trends in acute pancreatitis between infants/toddlers and older children. J Pediatr Gastroenterol Nutr. 2010;51(2):167-170. doi: 10.1097/MPG.0b013e3181cea545
  • Suzuki M, Sai JK, Shimizu T. Acute pancreatitis in children and adolescents. World J Gastrointest Pathophysiol. 2014;5(4):416-426. doi: 10.4291/wjgp.v5.i4.416
  • Wang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: etiology and common pathogenesis. World J Gastroenterol. 2009;15(12):1427-1430. doi: 10.3748/wjg.15.1427
  • Emiray EKD, Yilmaz M, Aliravci ID, Alkan S. COVID-19-Akut pankreatit ilişkisinin incelenmesi. IGUSABDER. 2021(13):130-143. doi: 10.38079/igusabder.815768
  • Ma MH, Bai HX, Park AJ, et al. Risk factors associated with biliary pancreatitis in children. J Pediatr Gastroenterol Nutr. 2012;54(5):651-656. doi: 10.1097/MPG.0b013e31823a897d
  • Trivedi CD, Pitchumoni C. Drug-induced pancreatitis: an update. J Clin Gastroenterol. 2005;39(8):709-716. doi: 10.1097/01.mcg.0000173929.60115.b4
  • Sánchez‐Ramírez CA, Larrosa‐Haro A, Flores‐Martínez S, Sánchez‐Corona J, Villa‐Gómez A, Macías‐Rosales R. Acute and recurrent pancreatitis in children: etiological factors. Acta Paediatrica. 2007;96(4):534-537. doi: 10.1111/j.1651-2227.2007.00225.x
  • Munoz A, Katerndahl DA. Diagnosis and management of acute pancreatitis. Am Fam Physician. 2000;62(1):164-174
  • Mekitarian Filho E, Carvalho WB, Silva FD. Acute pancreatitis in pediatrics: a systematic review of the literature. J de Pediatria. 2012;88(2):101-114. doi: 10.2223/JPED.2163
  • Grzybowska-Chlebowczyk U, Jasielska M, Flak-Wancerz A, et al. Acute pancreatitis in children. Prz Gastroenterol. 2018;13(1):69-75. doi: 10.5114/pg.2017.70470
  • Thai TC, Riherd DM, Rust KR. MRI manifestations of pancreatic disease, especially pancreatitis, in the pediatric population. Am J Gastroenterol. 2013;201(6):877-892. doi: 10.2214/AJR.13.10834
  • Appak YC, Karakoyun M, Cetin G, Akmaz N, Baran M. Diagnosis and management of pancreatitis in childhood: a single-centre experience. Iran J Pediatr. 2018;28(2):e62499. doi: 10.5812/ijp.62499
  • Hao S, Wu Y, Kang Y, Niu X, Zhu G, Huang W. A single-center analysis of primary nephrotic syndrome with acute pancreatitis in children. Medicine. 2020;99(27):e21056. doi: 10.1097/MD.0000000000021056
  • Sweeny KF, Lin TK, Nathan JD, et al. Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 2019;68(1):104-109. doi: 10.1097/MPG. 0000000000002145

Akut pankreatitli çocuklarda klinik özellikler, tanı, tedavi ve komplikasyonlar yönünden retrospektif analiz: tek merkez sonuçları

Year 2023, Volume: 4 Issue: 5, 456 - 465, 27.10.2023
https://doi.org/10.47582/jompac.1341423

Abstract

Amaç: Çalışmamızda pankreatit tanısıyla ayaktan ya da serviste takip edilen çocuk hastaların demografik ve klinik özelliklerini değerlendirmek, başvuru laboratuvar ve radyolojik bulgularıyla beraber uygulanan tedavileri, beslenme durumları, hastanede kalış süresi ve komplikasyonları incelemek amaçlanmıştır.
Yöntemler: Bu çalışma, 2011-2021 tarihleri arasında xxÜniversitesi Çocuk Gastroenteroloji bölümünde takip edilen, INSPPIRE kriterleri tarafından belirlenen 166 hastanın dosyalarının retrospektif olarak değerlendirilmesi ile gerçekleştirilmiştir. Hastaların yaşı, cinsiyeti, boyu, kilosu, bilinen hastalığı, kullanılan ilaçları, tarafımızca takip süresi, başvuru şikayetleri, tanının etiyolojik nedeni, pankreatit tipi, radyolojik görüntüleme ve laboratuvar bulguları, hastane yatış süreleri, uygulanan tedaviler, gelişen komplikasyonların verileri kaydedildi. PAPPS skoru, Ranson başvuru ve Ranson 48. saat skorları incelendi.
Bulgular: Hastaların 120’si (%72,3) akut, 25’i (%15,1) Kronik ve 21’i(%12,7) Akut rekürren Pankreatitti. Atlanta kriterlerinde göre %82,5’u hafif, %17,5’u orta şiddette tespit edildi. En sık başvuru yakınması karın ağrısı, en sık neden idiopatik idi. PAPPS skoru, Ranson başvuru skoru ile hastanede yatış süresi açısından pozitif zayıf bir korelasyon tespit edildi.
Sonuç: Pankreatit tanı ve takibinde hastalığın şiddetinin belirlenmesi ve etyolojisinin ortaya konması önemlidir.Hastaların erken tanı ve tedavisi konusunda standart yaklaşımların oluşturulması ve bunların uygulanması prognozu iyileştirici ve komplikasyonları önleyici etkilere yol açacaktır.

References

  • Pandol SJ, Forsmark CE. Consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer: achievements and future directions. Curr Opin Gastroenterol. 2021;37(5):486-490. doi: 10.1097/MPA.0000000000001167
  • Srinath AI, Lowe ME. Pediatric pancreatitis. Pediatr Rev. 2013;34(2):79-90. doi: 10.1542/pir.34-2-79
  • Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2018;16(3):175-184. doi: 10.1038/s41575-018-0087-5
  • Nydegger A, Heine RG, Ranuh R, Gegati-Levy R, Crameri J, Oliver MR. Changing incidence of acute pancreatitis: 10-year experience at the Royal Children’s Hospital, Melbourne. J Gastroenterol Hepatol. 2007;22(8):1313-1316. doi: 10.1111/j.1440-1746.2007.04936.x
  • Chang YJ, Chao HC, Kong MS, Hsia SH, Lai MW, Yan DC. Acute pancreatitis in children. Acta Paediatr. 2011;100(5):740-744. doi: 10.1111/j.1651-2227.2011.02158.x
  • Morinville VD, Husain SZ, Bai H, et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012;55(3):261-265. doi: 10.1097/MPG.0b013e31824f1516
  • Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A report of 320 cases of childhood pancreatitis: increasing incidence, etiologic categorization, dynamics, severity assessment, and outcome. Pancreas. 2017;46(1):110-115. doi: 10.1097/MPA.0000000000000733
  • Sweeny KF, Lin TK, Nathan JD, et al.Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 2019;68(1):104-109. doi: 10.1097/MPG.0000000000002145
  • DeBanto JR, Goday PS, Pedroso MRA, et al. Acute pancreatitis in children. Am J Gastroenterol. 2002;97(7):1726-1731. doi: 10.1111/j.1572-0241.2002.05833.x
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi: 10.1136/gutjnl-2012-302779
  • Lee PJ, Papachristou GI. New insights into acute pancreatitis. Nature reviews. Gastroenterol Hepatol. 2019;16(8):479-96. doi: 10.1038/s41575-019-0158-2
  • Basit H, Ruan GJ, Mukherjee S. Ranson criteria. 2018. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Bookshelf ID: NBK482345
  • Li Y, Dillman JR, Anton CG, et al. Secretin Improves Visualization of Nondilated Pancreatic Ducts in Children Undergoing MRCP. AJR Am J gastroentgenol. 2020;214(4):917-922. doi: 10.2214/AJR. 19.21798
  • Uc A, Fishman DS. Pancreatic Disorders. Pediatr Clin North Am. 2017;64(3): 685-706. doi: 10.1016/j.pcl.2017.01.010
  • Werlin SL, Kugathasan S FB. Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003;37(5):591-595. doi: 10.1097/00005176-200311000-00017
  • Fonseca Sepúlveda EV, Guerrero-Lozano R. Acute pancreatitis and recurrent acute pancreatitis: an exploration of clinical and etiologic factors and outcomes. Jornal de Pediatria. 2019;95(6):713-719. doi: 10.1016/j.jped.2018.06.011
  • Park AJ, Latif SU, Ahmad MU, et al. A comparison of presentation and management trends in acute pancreatitis between infants/toddlers and older children. J Pediatr Gastroenterol Nutr. 2010;51(2):167-170. doi: 10.1097/MPG.0b013e3181cea545
  • Suzuki M, Sai JK, Shimizu T. Acute pancreatitis in children and adolescents. World J Gastrointest Pathophysiol. 2014;5(4):416-426. doi: 10.4291/wjgp.v5.i4.416
  • Wang GJ, Gao CF, Wei D, Wang C, Ding SQ. Acute pancreatitis: etiology and common pathogenesis. World J Gastroenterol. 2009;15(12):1427-1430. doi: 10.3748/wjg.15.1427
  • Emiray EKD, Yilmaz M, Aliravci ID, Alkan S. COVID-19-Akut pankreatit ilişkisinin incelenmesi. IGUSABDER. 2021(13):130-143. doi: 10.38079/igusabder.815768
  • Ma MH, Bai HX, Park AJ, et al. Risk factors associated with biliary pancreatitis in children. J Pediatr Gastroenterol Nutr. 2012;54(5):651-656. doi: 10.1097/MPG.0b013e31823a897d
  • Trivedi CD, Pitchumoni C. Drug-induced pancreatitis: an update. J Clin Gastroenterol. 2005;39(8):709-716. doi: 10.1097/01.mcg.0000173929.60115.b4
  • Sánchez‐Ramírez CA, Larrosa‐Haro A, Flores‐Martínez S, Sánchez‐Corona J, Villa‐Gómez A, Macías‐Rosales R. Acute and recurrent pancreatitis in children: etiological factors. Acta Paediatrica. 2007;96(4):534-537. doi: 10.1111/j.1651-2227.2007.00225.x
  • Munoz A, Katerndahl DA. Diagnosis and management of acute pancreatitis. Am Fam Physician. 2000;62(1):164-174
  • Mekitarian Filho E, Carvalho WB, Silva FD. Acute pancreatitis in pediatrics: a systematic review of the literature. J de Pediatria. 2012;88(2):101-114. doi: 10.2223/JPED.2163
  • Grzybowska-Chlebowczyk U, Jasielska M, Flak-Wancerz A, et al. Acute pancreatitis in children. Prz Gastroenterol. 2018;13(1):69-75. doi: 10.5114/pg.2017.70470
  • Thai TC, Riherd DM, Rust KR. MRI manifestations of pancreatic disease, especially pancreatitis, in the pediatric population. Am J Gastroenterol. 2013;201(6):877-892. doi: 10.2214/AJR.13.10834
  • Appak YC, Karakoyun M, Cetin G, Akmaz N, Baran M. Diagnosis and management of pancreatitis in childhood: a single-centre experience. Iran J Pediatr. 2018;28(2):e62499. doi: 10.5812/ijp.62499
  • Hao S, Wu Y, Kang Y, Niu X, Zhu G, Huang W. A single-center analysis of primary nephrotic syndrome with acute pancreatitis in children. Medicine. 2020;99(27):e21056. doi: 10.1097/MD.0000000000021056
  • Sweeny KF, Lin TK, Nathan JD, et al. Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 2019;68(1):104-109. doi: 10.1097/MPG. 0000000000002145

Details

Primary Language English
Subjects Pediatric Gastroenterology
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Ersin BAŞKOCAGİL 0009-0007-3480-7143

Meltem GÜMÜŞ 0000-0002-9257-6597

Alaaddin YORULMAZ

Halil Haldun EMİROĞLU 0000-0002-1635-1150

Project Number -
Early Pub Date October 26, 2023
Publication Date October 27, 2023
Published in Issue Year 2023 Volume: 4 Issue: 5

Cite

AMA BAŞKOCAGİL E, GÜMÜŞ M, YORULMAZ A, EMİROĞLU HH. Retrospective analysis of clinical characteristics, diagnosis, treatment and complications of children with acute pancreatitis: single-center results. J Med Palliat Care / JOMPAC / jompac. October 2023;4(5):456-465. doi:10.47582/jompac.1341423

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



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