Çocuklarda Pankreatit: Tek Merkez Deneyimi

Year 2020, Volume: 14 Issue: 6, 522 - 527, 30.11.2020

Ayşegül Bükülmez , Pelin Balıkoğlu , Ayşe Tolunay Oflu , Çiğdem Özer Gökaslan

https://doi.org/10.12956/tchd.600267

Cited By: 1

Abstract

Amaç: Bu çalışmada akut pankreatit, akut rekürren pankreatit ve
kronik pankreatit tanısı ile izlenen çocukların klinik, laboratuvar ve
etiyolojik farklılıklarının değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Ocak 2014-Aralık 2017 tarihleri arasında
pankreatit tanısı ile izlenen çocukların tıbbi kayıtları retrospektif olarak
değerlendirilmiştir. Çalışmamıza Afyonkarahisar Sağlık Bilimleri Üniversitesi
Tıp Fakültesi Etik Kurulu’ndan onay alınmıştır. Olgularımız INSPPIRE grubu
tanımlamalarına göre akut pankreatit, akut rekürren pankreatit ve kronik pankretit
olarak sınıflandırılmıştır. Akut pankreatit (grup 1) ve akut rekürren ve kronik
pankreatit (grup 2) grupları arasında etiyoloji, demografik özellikler,
laboratuvar ve radyolojik bulgular karşılaştırılmıştır.

Bulgular: Akut pankreatit grubunda
(grup 1) 43 hasta (%78,2) mevcuttur. Grup 2; akut rekürren pankreatit tanısı
alan 8 olgu ve kronik pankreatit tanısı ile izlenen 4 olgu içermektedir [toplam
12 olgu (%21,8)]. Olgularımızın etiyolojisine bakıldığında grup 1’de idiyopatik
(%88,5), taş(%2,3), travma(%2,3) ve enfeksiyonlar (%4,6),koledok kisti (%2,3);
grup 2 de ise idiyopatik (%50), pankreatik kanalın konjenital anomalileri
(%8,3), alerji (%8,3), otoimmünite (%8,3) ve genetik sebeplerdir (%25). Her iki
grup arasında laboratuvar değerleri açısından istatistiksel bir fark
bulunmamıştır.

Sonuç: Çalışmamızda tüm gruplarda
genellikle pankreatitin nedeni tanımlanamamıştır. Akut pankreatit olgularında
etiyolojide ikinci sırada enfeksiyonlar mevcut olup, akut rekürren ve kronik
pankreatitte sık görülen nedenler genetik sebepler olarak bulunmuştur.

Keywords

akut pankreatit, akut tekrarlayan pankreatit, kronik pankreatit, etyoloji

PANCREATITIS IN CHILDREN: A SINGLE CENTER EXPERIENCE

Abstract

Objective: The aim of this study was to evaluate the clinical, laboratory
and etiological differences between children having acute pancreatitis, acute
recurrent pancreatitis and chronic pancreatitis.

Method: Medical records of children who were diagnosed with
pancreatitis between January 2014 and December 2017 were evaluated
retrospectively.  The study was approved
by the Ethics Committee of Afyonkarahisar University of Health Sciences. Our cases were classified as acute
pancreatitis, acute recurrent pancreatitis and chronic pancretitis according to
INSPPIRE group definitions.

Results:
Etiology, demographic characteristics, laboratory and radiological findings
were compared between acute pancreatitis (group 1) and acute recurrent and
chronic pancreatitis (group 2) groups. 43 patients (78.2%) were enrolled in
acute pancreatitis group (group 1). In group 2; 8 cases had acute recurrent
pancreatitis and 4 cases had chronic pancreatitis [a total of 12 cases (21.8%)].  the etiologies of our cases were examined;  Group 1 had idiopathic (88.5%), stone (2.3%),
trauma (2.3%), infections (4.6%) and choledochal cyst (2.3%), respectively. In
group 2, they were found to be idiopathic (50%), congenital anomalies of the
pancreatic duct (8.3%), allergy (8.3%), autoimmunity (8.3%) and genetic causes
(25%). There was no statistical difference between the groups in terms of
laboratory values. In our study, the cause of pancreatitis could not be generally
identified in all groups.

Conclusions:
 In cases having acute pancreatitis,
infections were the second most common etiology; and common causes of acute
recurrent and chronic pancreatitis have been found as genetic causes.

Keywords

acute pancreatitis, acute recurrent pancreatitis, chronic pancreatitis, etiology

References

• 1. Werlin SL, Wilschanski M. Acute pancreatitis. In: Kliegman RM, ed. Nelsons Essentials of Pediatrics. 20th ed. Philadelphia, PA: Saunders/Elsevier; 2016:1913-14. 2. Morinville, V. D., Lowe, M. E., Ahuja, M., Barth, B., Bellin, M. D., Davis, H., et.al. Design and implementation of INSPPIRE. J Pediatr Gastroenterol Nutr. 2014;59(3):360-364. doi:10.1097/MPG.0000000000000417. 3. Morinville V.D, Husain S.Z, Bai H, Barth B, Alhosh R, Durie P.R, et al. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012;55(3):261-265. doi:10.1097/MPG.0b013e31824f15164. Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175-184. doi:10.1038/s41575-018-0087-55. Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A Report of 320 Cases of Childhood Pancreatitis. Pancreas. 2017;46(1):110-115. doi:10.1097/MPA.00000000000007336. Kandula L, Lowe ME. Etiology and Outcome of Acute Pancreatitis in Infants and Toddlers. J Pediatr. 2008;152(1):106-110.e1. doi:10.1016/J.JPEDS.2007.05.0507. Pant C, Deshpande A, Olyaee M, Anderson M P, Bitar A, Steele M.I, et al. Epidemiology of Acute Pancreatitis in Hospitalized Children in the United States from 2000–2009. Rakonczay Z, ed. PLoS One. 2014;9(5):e95552. doi:10.1371/journal.pone.00955528. Ünlüsoy Aksu A, Sarı S, Eğritaş Gürkan Ö, Dalgıç B. Türk çocuklarda pankreatit: tek merkez deneyimi. Cukurova Med J. 2019;44(3):1-1. doi:10.17826/cumj.5116059. Alabdulkareem A, Almahmoud T, Al-Tahan H, Javad S, Al Hatlani M. Etiology and clinical characteristics of pediatric acute pancreatitis in Saudi Arabia: a 20-year experience from a single tertiary center. Int J Pediatr Adolesc Med. 2018;5(1):13-17. doi:10.1016/j.ijpam.2018.01.00110. Bai HX, Lowe ME, Husain SZ. What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr. 2011;52(3):262-270. doi:10.1097/MPG.0b013e3182061d7511. Taylor C.J, Chen K, Horvath K, Hughes D, Lowe M.E, Mehta D, et al. ESPGHAN and NASPGHAN Report on the Assessment of Exocrine Pancreatic Function and Pancreatitis in Children. 2015. doi:10.1097/MPG.00000000000008312. Abu-El-Haija M, Kumar S, Quiros J.A, Balakrishnan K, Barth B, Bitton S, et al. Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2018; 66(1):159-176. doi:10.1097/MPG.0000000000001715
• 2. Morinville, V. D., Lowe, M. E., Ahuja, M., Barth, B., Bellin, M. D., Davis, H., et.al. Design and implementation of INSPPIRE. J Pediatr Gastroenterol Nutr. 2014;59(3):360-364. doi:10.1097/MPG.0000000000000417.
• 3. Morinville V.D, Husain S.Z, Bai H, Barth B, Alhosh R, Durie P.R, et al. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012;55(3):261-265. doi:10.1097/MPG.0b013e31824f1516
• Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat Rev Gastroenterol Hepatol. 2019;16(3):175-184. doi:10.1038/s41575-018-0087-5
• Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A Report of 320 Cases of Childhood Pancreatitis. Pancreas. 2017;46(1):110-115. doi:10.1097/MPA.0000000000000733
• Kandula L, Lowe ME. Etiology and Outcome of Acute Pancreatitis in Infants and Toddlers. J Pediatr. 2008;152(1):106-110.e1. doi:10.1016/J.JPEDS.2007.05
• Pant C, Deshpande A, Olyaee M, Anderson M P, Bitar A, Steele M.I, et al. Epidemiology of Acute Pancreatitis in Hospitalized Children in the United States from 2000–2009. Rakonczay Z, ed. PLoS One. 2014;9(5):e95552. doi:10.1371/journal.pone.0095552
• Ünlüsoy Aksu A, Sarı S, Eğritaş Gürkan Ö, Dalgıç B. Türk çocuklarda pankreatit: tek merkez deneyimi. Cukurova Med J. 2019;44(3):1-1. doi:10.17826/cumj.511605
• Alabdulkareem A, Almahmoud T, Al-Tahan H, Javad S, Al Hatlani M. Etiology and clinical characteristics of pediatric acute pancreatitis in Saudi Arabia: a 20-year experience from a single tertiary center. Int J Pediatr Adolesc Med. 2018;5(1):13-17. doi:10.1016/j.ijpam.2018.01.001
• Bai HX, Lowe ME, Husain SZ. What have we learned about acute pancreatitis in children? J Pediatr Gastroenterol Nutr. 2011;52(3):262-270. doi:10.1097/MPG.0b013e3182061d75
• Taylor C.J, Chen K, Horvath K, Hughes D, Lowe M.E, Mehta D, et al. ESPGHAN and NASPGHAN Report on the Assessment of Exocrine Pancreatic Function and Pancreatitis in Children. 2015. doi:10.1097/MPG.000000000000083
• . Abu-El-Haija M, Kumar S, Quiros J.A, Balakrishnan K, Barth B, Bitton S, et al. Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report From the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2018; 66(1):159-176. doi:10.1097/MPG.0000000000001715