Division of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India.
Division of Paediatric Gastroenterology, Hepatology & Nutrition, Post Graduate Institute of Medical Education & Research, Chandigarh, 160012, India.
Pancreatology. 2020 Jun;20(4):659-664. doi: 10.1016/j.pan.2020.03.007. Epub 2020 Mar 13.
BACKGROUND & AIMS: Acute Pancreatitis (AP) tends to have a benign course in children. However there is a paucity of information with respect to severity of AP in children, the categorization of collections viz., walled off necrosis (WON)& pseudocyst and their natural history & outcomes.
A retrospective medical record review of 187 children with pancreatitis diagnosed and managed at our centre was performed.
101 children (59% boys, Median age 9yrs) had AP of which 37.6%, 60.4% and 2% had mild, moderately severe and severe AP. 61.4%(62) had PFC at diagnosis; 34%(21) acute pancreatic fluid collections (APFC) and 66%(41) acute necrotic collections (ANC). 52.3%(11of21) of APFC evolved into pseudocysts & 68.2%(28of41) of ANC into WON's. Drainage was required in 31%(12of39) of persisting collections, more frequently in children with traumatic AP. Percutaneous catheter drainage (PCD) was done in 6 children and endoscopic ultrasound (EUS) guided cystogastrostomy with placement of plastic or self expanding metal stents (SEMS) in 6 children.
Moderately severe AP is common in hospitalized children with AP with PFC developing in 61.4%, majority being APFC. 48% of APFC and 32% of ANC will resolve and the rest evolve into pseudocyst or WON. Spontaneous resolution is more likely in children with non -traumatic AP having pseudocysts rather than WON's.
儿童急性胰腺炎（AP）通常呈良性病程。然而，关于儿童 AP 的严重程度、积聚物的分类（如包裹性坏死（WON）和假性囊肿）及其自然病程和结局，相关信息非常有限。
我们对在我院诊断和治疗的 187 例胰腺炎患儿的病历进行了回顾性分析。
101 例患儿（男 59%，中位年龄 9 岁）患有 AP，其中轻度、中度重症和重症 AP 分别占 37.6%、60.4%和 2%。61.4%（62 例）患儿在诊断时存在胰腺假性囊肿（PFC）；34%（21 例）为急性胰腺液体积聚（APFC），66%（41 例）为急性坏死性积聚（ANC）。21 例 APFC 中有 52.3%（11 例）演变为假性囊肿，41 例 ANC 中有 68.2%（28 例）演变为 WON。持续积聚物中 31%（12 例）需要引流，外伤性 AP 患儿更常需要引流。39 例持续积聚物中有 6 例行经皮导管引流（PCD），6 例行内镜超声（EUS）引导下囊肿胃造口术，并放置塑料或自膨式金属支架（SEMS）。
在住院治疗的 AP 患儿中，中度重症 AP 较为常见，PFC 发生率为 61.4%，其中多数为 APFC。48%的 APFC 和 32%的 ANC 将得到解决，其余将演变为假性囊肿或 WON。非创伤性 AP 患儿更可能出现假性囊肿而非 WON 自发性消退。
