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儿童急性复发性胰腺炎:探索病因学因素。

Acute and recurrent pancreatitis in children: exploring etiological factors.

作者信息

Minen Federico, De Cunto Angela, Martelossi Stefano, Ventura Alessandro

机构信息

Institute for Maternal and Child Health - IRCCS Burlo Garofolo Trieste, University of Trieste, Trieste, Italy.

出版信息

Scand J Gastroenterol. 2012 Dec;47(12):1501-4. doi: 10.3109/00365521.2012.729084. Epub 2012 Sep 28.

Abstract

OBJECTIVE

Etiologies of acute pancreatitis (AP) in children are more variable than in adults, including drugs, traumas, infections and multisystem disorders as well as biliary anomalies. While causes of pancreatitis have been extensively analyzed, different series reported different causes. The aims of this study were: 1) to assess the etiological factors of acute and recurrent pancreatitis in a pediatric population from a tertiary care hospital; 2) to assess the usefulness of imaging studies in diagnosing etiologies of pancreatitis.

MATERIAL AND METHODS

Thirty-four children (median age 11 years, 23 males) with AP and 11 with recurrent pancreatitis were retrospectively studied to assess etiology of pancreatitis in children.

RESULTS

The most common etiologies of AP were medications (11/34) and biliary tract diseases (9/34), whereas systemic diseases accounted for a small percentage of case. Among patients with recurrent episodes, biliary anomalies were the most common cause (6/11), whereas only 2 out of 11 patients with recurrent pancreatitis presented a hereditary cause.

CONCLUSIONS

This study highlights that etiologies of AP in children are variable. Epidemiology of AP could be influenced by single center's characteristics. Anatomic anomalies should be ruled out and genetic causes should be considered in recurrent cases.

摘要

目的

儿童急性胰腺炎(AP)的病因比成人更为多样,包括药物、创伤、感染、多系统疾病以及胆道异常。虽然胰腺炎的病因已得到广泛分析,但不同系列报道的病因有所不同。本研究的目的是:1)评估一家三级护理医院儿科人群中急性和复发性胰腺炎的病因;2)评估影像学检查在诊断胰腺炎病因中的作用。

材料与方法

回顾性研究34例急性胰腺炎患儿(中位年龄11岁,男23例)和11例复发性胰腺炎患儿,以评估儿童胰腺炎的病因。

结果

急性胰腺炎最常见的病因是药物(11/34)和胆道疾病(9/34),而全身性疾病占病例的比例较小。在复发患者中,胆道异常是最常见的原因(6/11),而11例复发性胰腺炎患者中只有2例有遗传病因。

结论

本研究强调儿童急性胰腺炎的病因是多样的。急性胰腺炎的流行病学可能受单一中心特征的影响。对于复发病例,应排除解剖学异常并考虑遗传病因。

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