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Evaluation of Children with Acute Pancreatitis

Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 137 - 143, 10.12.2019

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.

References

  • References 1 Lowe ME, Whitcomb DC. Acute and chronic pancreatitis. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR, editors. Pediatric Gastrointestinal disease. Ontario: B.C. Decker; 2004.p.1584- 97. 2 Srinath AI, Lowe ME. Pediatric pancreatitis. Pediatr Rev 2013; 34(2): 79-90. 3 Park A, Latif SU, Shah AU, Tian J, Werlin S, Hsiao A, et al. Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis. J Pediatr Gastroenterol Nutr 2009; 49(3): 316-22. 4 DeBanto JR, Goday PS, Pedroso MR, Iftikhar R, Fazel A, Nayyar S, et al. Acute pancreatitis in children. Am J Gastroenterol 2002; 97(7): 1726-31. 5 Morinville VD, Barmada MM, Lowe ME. Increasing incidence of acute pancreatitis at an American pediatric tertiary care center: is greater awareness among physicians responsible? Pancreas 2010; 39(1): 5-8. 6 Mekitarian Filho E, Carvalho WB, Silva FD. Acute pancreatitis in pediatrics: a systematic review of the literature. J Pediatr (Rio J) 2012; 88(2): 101-14. 7 Chang YJ, Chao HC, Kong MS, Hsia SH, Lai MW, Yan DC. Acute pancreatitis in children. Acta Paediatr 2011; 100(5): 740-4. 8 Robertson MA. Acute and chronic pancreatitis. In: Walker WA, Durie PR, Hamilton JR, Walker-Smith WA, Watkins JB, editors. Pediatric Gastrointestinal Disease Pathophysiology, Diagnosis, Management. Philadelphia: B.C. Decker; 2000.p.1321-44. 9 Bradley EL, 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128(5): 586-90. 10 Pandol SJ, Saluja AK, Imrie CW, Banks PA. Acute pancreatitis: bench to the bedside. Gastroenterology 2007;132(3):1127-51. 11 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): 1313-6. 12 Agarwal N, Pitchumoni CS, Sivaprasad AV. Evaluating tests for acute pancreatitis. Am J Gastroenterol 1990; 85(4): 356-66. 13 Choi BH, Lim YJ, Yoon CH, Kim EA, Park YS, Kim KM. Acute pancreatitis associated with biliary disease in children. J Gastroenterol Hepatol 2003; 18(8): 915-21. 14 Bai HX, Lowe ME, Husain SZ. What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr 2011; 52(3): 262-70.
Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 137 - 143, 10.12.2019

Abstract

References

  • References 1 Lowe ME, Whitcomb DC. Acute and chronic pancreatitis. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR, editors. Pediatric Gastrointestinal disease. Ontario: B.C. Decker; 2004.p.1584- 97. 2 Srinath AI, Lowe ME. Pediatric pancreatitis. Pediatr Rev 2013; 34(2): 79-90. 3 Park A, Latif SU, Shah AU, Tian J, Werlin S, Hsiao A, et al. Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis. J Pediatr Gastroenterol Nutr 2009; 49(3): 316-22. 4 DeBanto JR, Goday PS, Pedroso MR, Iftikhar R, Fazel A, Nayyar S, et al. Acute pancreatitis in children. Am J Gastroenterol 2002; 97(7): 1726-31. 5 Morinville VD, Barmada MM, Lowe ME. Increasing incidence of acute pancreatitis at an American pediatric tertiary care center: is greater awareness among physicians responsible? Pancreas 2010; 39(1): 5-8. 6 Mekitarian Filho E, Carvalho WB, Silva FD. Acute pancreatitis in pediatrics: a systematic review of the literature. J Pediatr (Rio J) 2012; 88(2): 101-14. 7 Chang YJ, Chao HC, Kong MS, Hsia SH, Lai MW, Yan DC. Acute pancreatitis in children. Acta Paediatr 2011; 100(5): 740-4. 8 Robertson MA. Acute and chronic pancreatitis. In: Walker WA, Durie PR, Hamilton JR, Walker-Smith WA, Watkins JB, editors. Pediatric Gastrointestinal Disease Pathophysiology, Diagnosis, Management. Philadelphia: B.C. Decker; 2000.p.1321-44. 9 Bradley EL, 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg 1993; 128(5): 586-90. 10 Pandol SJ, Saluja AK, Imrie CW, Banks PA. Acute pancreatitis: bench to the bedside. Gastroenterology 2007;132(3):1127-51. 11 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): 1313-6. 12 Agarwal N, Pitchumoni CS, Sivaprasad AV. Evaluating tests for acute pancreatitis. Am J Gastroenterol 1990; 85(4): 356-66. 13 Choi BH, Lim YJ, Yoon CH, Kim EA, Park YS, Kim KM. Acute pancreatitis associated with biliary disease in children. J Gastroenterol Hepatol 2003; 18(8): 915-21. 14 Bai HX, Lowe ME, Husain SZ. What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr 2011; 52(3): 262-70.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Congress Proceedings
Authors

Burcu Ceylan Cura Yayla

Ceyda Tuna Kırsaçlıoğlu

Tülin Şaylı

Publication Date December 10, 2019
Acceptance Date January 16, 2020
Published in Issue Year 2019 Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri

Cite

Vancouver Cura Yayla BC, Tuna Kırsaçlıoğlu C, Şaylı T. Evaluation of Children with Acute Pancreatitis. pediatr pract res. 2019;7(Ek):137-43.