Al Hindi Saeed, Khalaf Zahra, Nazzal Khaled, Nazzal Osama, Ahmed Alya, Alshaibani Lama
Department of Pediatric Surgery, Salmaniya Medical Complex, Manama, BHR.
Department of Surgery, Ibn Al-Nafees Hospital, Manama, BHR.
Cureus. 2021 May 6;13(5):e14871. doi: 10.7759/cureus.14871.
Objectives The clinical course and progression of acute pancreatitis are poorly understood to date, necessitating more studies of clinical profiles during the disease. Moreover, understanding the etiologies and clinical presentations of acute pancreatitis (AP) in children can contribute to early diagnosis and, hence, earlier interventions. Therefore, this article aims to study the clinical profiles of children with acute pancreatitis (AP) in relation to complications and other variables. Study design We retrospectively studied 56 patients who presented with AP to the pediatric department in Salmaniya Medical Complex between January 2006 and December 2017. Cases of chronic pancreatitis and ages above 12 years were excluded. The data concerned demographics, etiology, clinical data, hospital course, and outcomes. Results The study included 56 patients aged a mean of 8.46 years (male:female - 33:23). The average hospital stay was 7.68 days. Patients received parenteral feeds a mean of 2.77 days. All patients had an ultrasound, nine required CT scans (16.1%), and five MRIs (8.9%). There were 18 local complications (32.1%): pseudocysts (n=3, 5.36%), cholangitis (n=2, 3.6%), and edema (n=13, 23.2%). There were 23 intensive care unit (ICU) admissions (41.1%). No mortalities occurred but there were six recurrences (10.7%). Symptoms of abdominal pain, vomiting, fever, and nausea occurred in 100%, 57.1%, 35.7%, and 23.2% of patients, respectively. Etiologies were 41.1% biliary, 23.2% idiopathic, 19.6% traumatic, and 8.93% drug-induced. Leukocytes were elevated in 20 patients (35.7%), c-reactive protein (CRP) in five (8.93%), serum amylase in 45 (80.4%), and urinary amylase in all 56 patients (100%). Conclusion Most pediatric AP cases were attributed to biliary causes followed by trauma. Age was significantly correlated with complication rates (P=0.013). Abdominal pain was a more common symptom than vomiting. Leukocytosis was associated with ICU admissions. There was no significant relation between c-reactive protein, serum amylase, or urinary amylase, and complications or ICU admissions. Pediatric AP was self-limiting and there were no fatalities.
目的 迄今为止，急性胰腺炎的临床病程和进展仍未得到充分了解，因此需要对该疾病的临床特征进行更多研究。此外，了解儿童急性胰腺炎（AP）的病因和临床表现有助于早期诊断，从而实现更早的干预。因此，本文旨在研究儿童急性胰腺炎（AP）的临床特征及其与并发症和其他变量的关系。
研究设计 我们回顾性研究了2006年1月至2017年12月期间在萨勒曼尼亚医疗中心儿科就诊的56例急性胰腺炎患者。排除慢性胰腺炎病例和12岁以上患者。收集的数据包括人口统计学、病因、临床资料、住院病程和结局。
结果 该研究纳入了56例患者，平均年龄8.46岁（男∶女 = 33∶23）。平均住院时间为7.68天。患者平均接受肠外营养2.77天。所有患者均接受了超声检查，9例（16.1%）需要进行CT扫描，5例（8.9%）需要进行MRI检查。有18例局部并发症（32.1%）：假性囊肿（n = 3，5.36%）、胆管炎（n = 2，3.6%）和水肿（n = 13，23.2%）。有23例（41.1%）患者入住重症监护病房（ICU）。无死亡病例，但有6例复发（10.7%）。100%的患者出现腹痛症状，57.1%的患者出现呕吐症状，35.7%的患者出现发热症状，23.2%的患者出现恶心症状。病因分别为：胆源性41.1%、特发性23.2%、创伤性19.6%、药物性8.93%。20例患者（35.7%）白细胞升高，5例患者（8.93%）C反应蛋白（CRP）升高，45例患者（80.4%）血清淀粉酶升高，所有56例患者（100%）尿淀粉酶升高。
结论 大多数儿童急性胰腺炎病例归因于胆源性病因，其次是创伤。年龄与并发症发生率显著相关（P = 0.013）。腹痛是比呕吐更常见的症状。白细胞增多与入住ICU相关。C反应蛋白、血清淀粉酶或尿淀粉酶与并发症或入住ICU之间无显著关系。儿童急性胰腺炎具有自限性，无死亡病例。
