Vepakomma Deepti
Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
J Indian Assoc Pediatr Surg. 2020 Jan-Feb;25(1):22-27. doi: 10.4103/jiaps.JIAPS_223_18. Epub 2019 Nov 27.
The aim of this study was to analyze the clinical spectrum of pediatric pancreatitis and review current literature with regard to concepts of disease and management approaches.
This is a retrospective analysis of pancreatitis patients admitted to a tertiary referral pediatric surgical unit from March 2013 to September 2018.
There were 106 patients from 1 year to 18 years with median age group between 11 and 15 years and equal gender distribution. Sixty-two children had acute pancreatitis (AP), with 13 of them having recurrent episodes. Forty-four patients had chronic pancreatitis (CP). Definite etiology was found in 11 AP patients. All patients had radiological changes. All AP patients were treated symptomatically except those with correctable underlying etiology. Sixteen with CP required intervention in the form of endoscopic retrograde cholangiopancreatography sphincterotomy/stenting or surgery. There were two mortalities. One with acute necrotizing pancreatitis and one CP girl due to the complication of diabetes mellitus, unrelated to episode of pancreatitis. All others are well at the last follow-up.
Pediatric pancreatitis is a disease with a wide spectrum, but management can be standardized. Newer studies reveal that certain genetic mutations make children more susceptible to pancreatitis. Increasing incidence must prompt us to evaluate further so as to better equip ourselves to managing this disease entity in all its forms and evolve preventive strategies.
本研究旨在分析小儿胰腺炎的临床谱,并回顾有关疾病概念和管理方法的当前文献。
这是一项对2013年3月至2018年9月入住三级转诊小儿外科病房的胰腺炎患者的回顾性分析。
共有106例年龄在1岁至18岁之间的患者,中位年龄组在11岁至15岁之间,性别分布均衡。62例儿童患有急性胰腺炎(AP),其中13例有复发发作。44例患者患有慢性胰腺炎(CP)。在11例AP患者中发现了明确病因。所有患者均有影像学改变。除有可纠正的潜在病因的患者外,所有AP患者均接受对症治疗。16例CP患者需要接受内镜逆行胰胆管造影括约肌切开术/支架置入术或手术等干预措施。有2例死亡。1例死于急性坏死性胰腺炎,1例CP女孩死于糖尿病并发症,与胰腺炎发作无关。所有其他患者在最后一次随访时情况良好。
小儿胰腺炎是一种具有广泛谱的疾病,但管理可以标准化。最新研究表明,某些基因突变使儿童更容易患胰腺炎。发病率的上升促使我们进一步评估,以便更好地应对这种疾病的各种形式并制定预防策略。