Abu-El-Haija Maisam, Lin Tom K, Nathan Jaimie D
aDivision of Pediatric Gastroenterology, Hepatology and Nutrition bDivision of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Curr Opin Pediatr. 2017 Oct;29(5):592-597. doi: 10.1097/MOP.0000000000000528.
Pediatric acute pancreatitis has been on the rise in the last decades, with an incidence close to adult pancreatitis. In the majority of cases acute pancreatitis resolves spontaneously, but in a subset of children the disease progresses to severe acute pancreatitis with attendant morbidity and mortality.
Pediatric acute pancreatitis in this era is recognized as a separate entity from adult acute pancreatitis given that the causes and disease outcomes are different. There are slow but important advances made in understanding the best management for acute pancreatitis in children from medical, interventional, and surgical aspects.
Supportive care with fluids, pain medications, and nutrition remain the mainstay for acute pancreatitis management. For complicated or severe pancreatitis, specialized interventions may be required with endoscopic or drainage procedures. Surgery has an important but limited role in pediatric acute pancreatitis.
在过去几十年中,儿童急性胰腺炎的发病率呈上升趋势,接近成人胰腺炎。在大多数情况下,急性胰腺炎会自发缓解,但在一部分儿童中,疾病会进展为重症急性胰腺炎,随之而来的是发病率和死亡率。
鉴于病因和疾病转归不同,这个时代的儿童急性胰腺炎被认为是与成人急性胰腺炎不同的独立疾病实体。在从医学、介入和外科方面理解儿童急性胰腺炎的最佳管理方面,虽然进展缓慢但意义重大。
液体、止痛药物和营养支持治疗仍然是急性胰腺炎管理的主要手段。对于复杂或重症胰腺炎,可能需要通过内镜或引流手术进行专门干预。手术在儿童急性胰腺炎中具有重要但有限的作用。