Al Droubi Belal, Altamimi Eyad
Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Pediatrics, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Front Pediatr. 2022 Jul 1;10:908472. doi: 10.3389/fped.2022.908472. eCollection 2022.
There is still much to understand and discover regarding pediatric pancreatitis. The etiology, clinical presentation, and prognosis of pancreatitis differs considerably between young children and adults. The incidence of pancreatitis has been increasing; it is no longer as rare in children as previously thought and could cause significant morbidity and mortality when severe.
In this retrospective study conducted at a tertiary care hospital in Jordan, we present a cohort of children with 64 episodes of acute pancreatitis.
While abdominal pain was the most common presenting complaint in our cohort (97%), the classical features of radiation to the back and relief by the forward-lean position were observed in only one-third of our patients. Compared to serum amylase, serum lipase had a higher sensitivity for detecting pancreatitis (98 vs. 67%). Abdominal ultrasound is a non-invasive, widely available imaging modality; when performed, it revealed an enlarged pancreas in almost 60% of the patients. However, abdominal ultrasonography is often limited by the presence of excessive bowel gas. Anatomical abnormalities were the most common etiologies of pancreatitis (29%), followed by idiopathic pancreatitis (21%), and biliary causes (21%).
In our cohort, serum lipase was a better diagnostic tool compared to serum amylase. Congenital biliary-pancreatic abnormalities were the most common causes of acute pancreatitis in our cohort. Almost half of these patients developed recurrent acute pancreatitis. The prevalence of pancreatic pseudocysts was 16.7%, and nearly half of them required an intervention.
关于小儿胰腺炎仍有许多需要了解和探索的地方。胰腺炎的病因、临床表现和预后在幼儿和成人之间有很大差异。胰腺炎的发病率一直在上升；它在儿童中不再像以前认为的那样罕见，严重时可导致显著的发病率和死亡率。
在约旦一家三级医疗中心进行的这项回顾性研究中，我们呈现了一组患有64例急性胰腺炎发作的儿童队列。
虽然腹痛是我们队列中最常见的主诉（97%），但只有三分之一的患者出现了向背部放射及前倾位缓解的典型特征。与血清淀粉酶相比，血清脂肪酶对检测胰腺炎具有更高的敏感性（98%对67%）。腹部超声是一种非侵入性、广泛可用的成像方式；在进行检查时，几乎60%的患者显示胰腺肿大。然而，腹部超声检查常因肠道气体过多而受到限制。解剖学异常是胰腺炎最常见的病因（29%），其次是特发性胰腺炎（21%）和胆源性病因（21%）。
在我们的队列中，与血清淀粉酶相比，血清脂肪酶是一种更好的诊断工具。先天性胆胰异常是我们队列中急性胰腺炎最常见的病因。这些患者中几乎一半发展为复发性急性胰腺炎。胰腺假性囊肿的患病率为16.7%，其中近一半需要干预。
