Evaluation of Children with Acute Pancreatitis

Abstract

Although acute pancreatitis (AP) is uncommon in children, causes significant morbidity and mortality. This study aims to evaluate the clinical and laboratory findings, treatment approaches, complications of children with acute pancreatitis. Material and methods: Thirty children who were diagnosed as acute pancreatitis during January 2008-April 2013 were evaluated. Results: The most common etiology of acute pancreatitis was the drugs (30%), particularly L- asparaginase (44.5%). The biliary tract diseases (26.7%), infection (16.7%), hyperlipidemia (10%), cystic fibrosis (3.3%), and post-endoscopic retrograde cholangiopancreatography pancreatitis (3.3%) were other causes, and among 10%, no reason was detected. Abdominal pain (83,3%), nausea (70%), loss of appetite (63.3%), vomiting (56.7%), and fever (20%) were the most common symptoms. In 86.6% of cases amylase, in 73.9% lipase, and in 66.7% pancreatic amylase were elevated three times the upper limit of normal. The alanine transaminase, total and direct bilirubin levels in not drug-induced pancreatitis were higher than drug-induced pancreatitis (p<0.05). Ultrasonography, abdominal tomography, magnetic resonance cholangiopancretography revealed pancreatitis related changes 63.3%, 85%, 70% of patients, respectively. Oral feeding was started on 4 ± 5.6 days, with polymeric diet (30%), and medium chain triglyceride rich enteral diet (70%). The length of hospitalization was 16.5 ± 15.1 days (4-66 days). The patients fed with polymeric diet had a shorter hospitalization duration (p<0.05). The delayed initiation of oral feeding caused longer LOH (p<0.001). Pseudocyst (6,7%), sepsis (6.7%), and necrosis (3.3%) were the complications developed in patients. Conclusion: Consequently, this study underlines the children with acute abdominal pain, especially who use drugs like asparaginase and valproic acid, or that are known to have gallstone/biliary sludge, need to be examined for acute pancreatitis through pancreatic enzymes and ultrasonography. Moreover, the study also highlights that early feeding in acute pancreatitis is related with shorter hospitalization duration.

Keywords

• Acute pancreatitis

References

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