Division of Pediatric Gastroenterology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.
J Pediatr. 2013 Apr;162(4):788-92. doi: 10.1016/j.jpeds.2012.09.037. Epub 2012 Oct 25.
To describe the etiologic factors, course, and outcome of acute necrotizing pancreatitis in children.
We performed a retrospective study of children with necrotizing pancreatitis diagnosed during the last 21 years at Yale-New Haven Children's Hospital. Computed tomography (CT) criteria were used to diagnose necrotizing pancreatitis and to assess severity index. Charts were reviewed to collect demographics, etiology, details of hospital stay, complications, and outcome.
Seven children (mean age, 11.6 years; range, 4-17.8 years) had necrotizing pancreatitis. Etiologic factors were medications, diabetes, and gallstones. All had prolonged hospitalization (9-40 days; mean, 20 days) and 5 patients required admission to the pediatric intensive care unit. During the hospital stay, patients developed complications involving the respiratory, hematologic, renal, metabolic, and circulatory systems. All patients had aggressive supportive medical therapy, and none required surgery. There were no deaths attributable to pancreatitis. Late complications after hospital discharge occurred in 5 patients and included pseudocysts, transient hyperglycemia, diabetes, and pancreatic exocrine insufficiency. The CT severity index correlated with the risk of complications.
A cute necrotizing pancreatitis has a variable etiology in children. CT scan is useful in the diagnosis and assessment of severity. Necrotizing pancreatitis in children is associated with severe acute and late complications and requires intensive medical therapy.
描述儿童急性坏死性胰腺炎的病因、病程和转归。
我们对过去 21 年来在耶鲁纽黑文儿童医院诊断为坏死性胰腺炎的儿童进行了回顾性研究。使用计算机断层扫描（CT）标准来诊断坏死性胰腺炎并评估严重指数。回顾图表以收集人口统计学、病因、住院详细信息、并发症和结果。
7 名儿童（平均年龄 11.6 岁；范围 4-17.8 岁）患有坏死性胰腺炎。病因因素是药物、糖尿病和胆结石。所有患者均延长住院时间（9-40 天；平均 20 天），5 名患者需要入住儿科重症监护病房。在住院期间，患者出现涉及呼吸系统、血液系统、肾脏、代谢和循环系统的并发症。所有患者均接受了积极的支持性医疗治疗，无需手术。没有因胰腺炎导致的死亡。5 名出院后的患者出现迟发性并发症，包括假性囊肿、短暂性高血糖、糖尿病和胰腺外分泌功能不全。CT 严重指数与并发症风险相关。
儿童急性坏死性胰腺炎的病因各不相同。CT 扫描有助于诊断和评估严重程度。儿童坏死性胰腺炎与严重的急性和迟发性并发症相关，需要强化的医疗治疗。
