[Acute pancreatitis in children]. / Pancreatitis aguda en la infancia.

INTRODUCTION: Lately, there has been an increase in incidence of acute pancreatitis in childhood. Fortunately, 80% of cases are mild and do not require surgical approach. Several etiologic factors have been implicated, such as infections, trauma, congenital anomalies, drugs, biliary diseases. The aim of this study was to assess etiology, clinical features and outcomes of children with acute pancreatitis treated at our center. MATERIALS AND METHODS: A retrospective chart review of our cases of acute pancreatitis in patients younger than 16 years old was performed. RESULTS: 24 cases of acute pancreatitis were found from 1998 to 2010. Mean age was 8.75 years. There were 7 boys and 17 girls. The main clinical manifestations were abdominal pain, vomiting and abdominal distention. Mean amylase level was 1565 UI/L. There was one patient with normal serum amylase levels. Serum lipase was required in two patients (239 UI/L and 5,980 UI/L). Ultrasound showed pancreatic lesion in 79.2% of cases. Severe pancreatitis was presented in two cases, due to renal failure and pancreatic necrosis. Surgery was performed in 6 cases (3 cholecystectomies, 1 choledocal cyst resection, 1 percutaneous pseudocyst drainage and 1 necrosectomy) Pancreatic complications were found in 20.8% of cases (4 pseudocysts y 1 pancretic necrosis) Several causes were found: idiophatic, secondary to ERCP, congenital anomalies, drugs, infections, biliary disease and trauma. Mean hospital stay was 25.65 days. There were no deaths due to acute pancreatitis. CONCLUSIONS: There are several causes of acute pancreatitis in children. Some cases may present normoamilasemia, situation, in which serum lipase and clinical and radiological criteria are pivotal. Prospective studies evaluating etiological factors and incidence are required.

Pancreatitis aguda en la infancia / Acute pancreatitis in children

Introducción. La pancreatitis aguda en la infancia ha presentado un incremento en su incidencia. El 80% de los casos es leve y no requiere cirugía. Su etiología es diversa, destacándose los casos secundarios a traumatismos, infecciones, anomalías estructurales y medicamentos. El objetivo del presente estudio fue determinar la distribución etiológica, las características clínicas y los resultados de los casos de pancreatitis aguda en los niños tratados en nuestro centro. Materiales y métodos. Se efectuó una revisión retrospectiva de los casos de pancreatitis aguda en pacientes menores de 16 años atendidos en nuestro hospital entre los años 1998 a 2010. Resultados. Se presentaron 24 casos de pancreatitis aguda durante un período de 12 años. La edad media fue de 8,75 años. El síntoma principal fue dolor abdominal, seguido de vómitos y distensión abdominal. El valor medio de amilasa al inicio del episodio fue de 1.565 UI/L. Una paciente presentó pancreatitis aguda con normoamilasemia. El 79,2% de los casos tuvieron hallazgos ecográficos compatibles con pancreatitis aguda y seis casos requirieron intervención quirúrgica. El porcentaje de complicaciones pancreáticas fue del 20,8%. La distribución etiológica fue múltiple, siendo la idiopática la más común, seguida de secundaria a colangiopancreatografía, a malformaciones congénitas y de origen medicamentoso. No hubo mortalidad atribuible a la pancreatitis aguda. Conclusiones. La pancreatitis aguda en la infancia presenta una etiología muy variada. Algunos casos pueden debutar con normoamilasemia, situación en la que la determinación de la lipasa sérica es fundamental. Se requieren estudios prospectivos para evaluar la distribución etiológica y la incidencia de la pancreatitis aguda en la infancia (AU)

Introduction. Lately, there has been an increase in incidence of acute pancreatitis in childhood. Fortunately, 80% of cases are mild and do not require surgical approach. Several etiologic factors have been implicated, such as infections, trauma, congenital anomalies, drugs, biliary diseases. The aim of this study was to assess etiology, clinical features and outcomes of children with acute pancreatitis treated at our center. Materials and methods. A retrospective chart review of our cases of acute pancreatitis in patients younger than 16 years old was performed. Results. 24 cases of acute pancreatitis were found from 1998 to 2010. Mean age was 8.75 years. There were 7 boys and 17 girls. The main clinical manifestations were abdominal pain, vomiting and abdominal distention. Mean amylase level was 1565 UI/L. There was one patient with normal serum amylase levels. Serum lipase was required in two patients (239 UI/L and 5,980 UI/L). Ultrasound showed pancreatic lesion in 79.2% of cases. Severe pancreatitis was presented in two cases, due to renal failure and pancreatic necrosis. Surgery was performed in 6 cases (3 cholecystectomies, 1 choledocal cyst resection, 1 percutaneous pseudocyst drainage and 1 necrosectomy) Pancreatic complications were found in 20.8% of cases (4 pseudocysts y 1 pancretic necrosis) Several causes were found: idiophatic, secondary to ERCP, congenital anomalies, drugs, infections, biliary disease and trauma. Mean hospital stay was 25.65 days. There were no deaths due to acute pancreatitis. Conclusions. There are several causes of acute pancreatitis in children. Some cases may present normoamilasemia, situation, in which serum lipase and clinical and radiological criteria are pivotal. Prospective studies evaluating etiological factors and incidence are required (AU)