Akut Pankreatitli Olgularımız: Tek Merkez Beş Yıllık Deneyim

Yıl 2021, Cilt: 11 Sayı: 3, 262 - 266, 24.05.2021

Özlem Tolu Kendir Mehmet Ağın Hayri Yılmaz Sinem Sarı Gökay Gokhan Tumgor

https://doi.org/10.16899/jcm.878153

Cited By: 1

Öz

Amaç: Bu çalışmada; üçüncü basamak bir çocuk acil ünitesinde akut pankreatit tanısı almış hastaların klinik ve laboratuvar özelliklerinin incelenmesi, karın ağrılı çocuk hastaların ayırıcı tanısında akut pankreatitin önemine dikkat çekilmesi amaçlanmıştır.
Yöntem: Çalışmaya Çukurova Üniversitesi Tıp Fakültesi Çocuk Acil Bilim Dalı’nda 5 yıllık sürede akut pankreatit tanısı almış çocuk hastalar dahil edildi. Hastalar akut ve tekrarlayan akut pankreatit olarak iki gruba ayrıldı. Hastaların klinik ve laboratuvar verileri geriye dönük incelendi. Modifiye Ranson kriterlerine göre akut pankreatit risk faktörleri belirlendi.
Bulgular: Çalışma süresince akut pankreatit tanısı alan 53 hasta çalışmaya alındı. Hastalar toplamda 116 kez atak geçirmişti. Yaş ortalamaları 10,6±4,4 yıl (en küçük:0,5, en yüksek:17,5) ve 28 (%52,8)’i kız idi. 22’si (%41,5) ≥2 atak geçirmişti. Akut pankreatit etiyolojisi 20 (%38) hastada belirlenemez iken, 10 hastada (%18,8) hiperlipidemi saptandı.
Sonuç: Çocuk acil servislere karın ağrısı ile başvuran hastaların ayırıcı tanısında akut pankreatit düşünülmeli, konu ile ilgili farkındalık arttırılmalıdır.

Anahtar Kelimeler

Akut Pankreatit,, Akut Tekrarlayan Pankreatit, Karın Ağrısı

Evaluation of Acute Pancreatitis Patients: Single Center Five Years’ Experience

Öz

ABSTRACT
Aim: In the present study, the purpose was to examine the clinical and laboratory characteristics of patients diagnosed with Acute Pancreatitis in a third-line Children’s Emergency Department, and to draw attention to the importance of Acute Pancreatitis in the differential diagnosis of children admitting with abdominal pain.
Materials and Methods: The child patients who were diagnosed with acute pancreatitis at Çukurova University Faculty of Medicine, Department of Pediatric Emergency Medicine for a period of 5 years were included in the study. The patients were divided into two groups as Acute Pancreatitis and Recurrent Acute Pancreatitis. The clinical and laboratory data of the patients were examined retrospectively. Acute pancreatitis risk factors were determined according to the Modified Ranson Criteria.
Results: A total of 53 patients who were diagnosed with acute pancreatitis were included in the study. The patients had had attacks for a total of 116 times. The mean age of the patients was 10.6±4.4 years (minimum: 0.5, maximum: 17.5), 28 (52.8%) were girls, and 22 (41.5%) had had ≥2 attacks. The etiology of Acute Pancreatitis could not be determined in 20 (38%) patients, and hyperlipidemia was detected in 10 patients (18.8%).
Conclusion: Acute Pancreatitis should be considered in the differential diagnosis of patients admitting to Emergency Departments with abdominal pain, and the awareness about the subject should be increased.
Keyword: Acute Pancreatitis, Acute Recurrent Pancreatitis, Abdominal Pain.

Anahtar Kelimeler

Acute Pancreatitis, Acute Recurrent Pancreatitis, Abdominal Pain.

Kaynakça

• 1. Pekmezci S. Acute pancreatitis approach and treatment. Hepato-Biliary System And Pancreatic Diseases Symposium Series. 2002; 28: 239-262.
• 2. Yeşim Ö. Acute pancreatitis in childhood. Journal of Child Health and Diseases. 2007; 50: 146-153.
• 3. Tamer A, Yaylacı S, Demirsoy H, Nalbant A, Genç A, Demirci H, Demir MV, Uslan MI. Retrospective Analyses of The Acute Pancreatitis. Sakaryam j. 2011; 1(1): 17-21.
• 4. Sekimoto M, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and out comepredictors in acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006; 13: 10-24.
• 5. Kimura Y, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: epidemiology, etiology, natural history, and outcome predictors in acute pancreatitis. Hepatobiliary Pancreat Surg. 2006; 13(1): 10-24.
• 6. Peery AF, Dellon ES, Lund J, et al. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology. 2012; 143: 1179.
• 7. Toouli J, Brooke-Smith M, Bassi C, et al. Guidelines for the management of acute pancreatitis. J Gastroenterol Hepatol. 2002; 17: 15-39.
• 8. Ippisch HM, Alfaro-Cruz L, Fei L, Zou Y, Thompson T, Abu-EL-Haija M. Hypertriglyceridemia Induced Pancreatitis. Pancreas. 2020; 49: 429–434.
• 9. Aksu AÜ, Sarı S, Gürken ÖE, Dalgıç B. Pancreatitis in Turkish children: a single center experience. Cukurova Med J. 2019; 44(3): 991-998.
• 10. Vepakomma D. Pediatric Pancreatitis: Outcomes and Current Understanding. J Indian Assoc Pediatr Surg. 2020; 25: 22-7.
• 11. Morinville VD, Husain SZ, Bai H, Barth B, Alhosh R, Durie PR et al. INSPPIRE Group. Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012; 55: 261-5.
• 12. 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: 5-8.
• 13. Werlin S, Kugathasan S, Cowan B. Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003; 37: 592–5.
• 14. Weizman Z, Durie P. Acutepancreatitis in childhood. J Pediatr 1988; 113: 24–9.
• 15. Pietzak M, Thomas D. Pancreatitis in childhood. Pediatrics Rev 2000; 21: 406–12.
• 16. Davenport M. Acute and chronic pancreatitis. Indian J Pediatr. 2002; 69: 801–7.
• 17. Lopez M. The changing incidence of acute pancreatitis in children: a single-instituti on perspective. J Pediatr. 2002; 140: 622–4.
• 18. Choudari CP, Imperiale TF, Sherman S, Fogel E, Lehman GA. Risk of pancreatitis with mutation of the cystic fibrosis gene. Am J Gastroenterol. 2004; 99: 1358–63.
• 19. Koizumi M, Takada T, Kawarada Y, et al. JPN Guidelines for the management of acute pancreatitis: diagnostic criteria for acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006; 13: 25-32.
• 20. Bradley EL. 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.
• 21. Balani AR, Grendell JH. Drug-induced pancreatitis: incidence, management and prevention. Drug Saf. 2008; 31(10): 823-37.
• 22. Elmas N. The role of diagnostic radiology in pancreatitis. European Journal of Radiology. 2001; 38: 120-132.
• 23. Taylor CJ, Chen K, Horvath K, Hughes D, Lowe ME, Mehta D et al. ESPGHAN and NASPGHAN Report on the assessment of exocrine pancreatic function and pancreatitis in children. J Pediatr Gastroenterol Nutr. 2015; 61: 144-53.
• 24. Schütte K, Malfertheiner P. Markers for predicting severity and progression of acute pancreatitis. Best Pract Res Clin Gastroenterol. 2008; 22(1): 75-90.