Mirza Nida, Mehta Sagar, Kumar Karunesh, Malhotra Smita, Sibal Anupam
Department of Pediatrics, SAIMS, Indore, Madhya Pradesh, India.
Department of Pediatric Gastroenterology, Indraprastha Apollo Hospital, New Delhi, India.
J Indian Assoc Pediatr Surg. 2023 Jan-Feb;28(1):35-40. doi: 10.4103/jiaps.jiaps_36_22. Epub 2022 Dec 12.
There has been an increase in incidence of pancreatitis in children all over the world; studies in developed countries shown multiple etiological factors such as drugs, infections, trauma, anatomic abnormalities, and/or genetic pancreatitis in children; however, there are sparse data from the developing countries. This study was undertaken to determine the characteristics of Indian children with acute pancreatitis (AP), mainly the clinical features, etiology, complication, association, genetic factors, and outcome and recurrence.
We performed a retrospective study of all patients under the age of 18 years, who had a final diagnosis of pancreatitis admitted at our center between 2017 and 2019.
During the 3-year period from 2017 to 2019, 40 patients were admitted at our center with AP. We found a definite etiology in 62.5% cases of patients, which were broadly grouped into seven etiologies: structural, genetic, drug induced, concurrent illness, cholelithiasis related, metabolic, and autoimmune. Recurrence of acute episodes was noted in 13 patients (32.5%). Of these, 11 were found to have a genetic mutation, underlying structural abnormality, or concurrent illness. In our study, we found that 23 patients (57.5%) had mild AP, while 14 patients (35%) had moderately severe pancreatitis; however, 3 patients (7.5%) had severe AP.
We found that most cases of pancreatitis in children were of mild severity, and the etiology was quite different than adults, and most cases of acute recurrent pancreatitis have a definite etiology of either genetic mutation or structural anomaly.
全球儿童胰腺炎的发病率呈上升趋势;发达国家的研究表明,儿童胰腺炎存在多种病因,如药物、感染、创伤、解剖异常和/或遗传性胰腺炎;然而,发展中国家的数据却很少。本研究旨在确定印度急性胰腺炎(AP)患儿的特征,主要包括临床特征、病因、并发症、关联因素、遗传因素以及结局和复发情况。
我们对2017年至2019年期间在本中心确诊为胰腺炎的所有18岁以下患者进行了回顾性研究。
在2017年至2019年的3年期间,本中心收治了40例AP患儿。我们在62.5%的病例中发现了明确的病因,大致可分为七种病因:结构性、遗传性、药物性、并发疾病、胆石症相关、代谢性和自身免疫性。13例患者(32.5%)出现急性发作复发。其中,11例被发现存在基因突变、潜在的结构异常或并发疾病。在我们的研究中,我们发现23例患者(57.5%)患有轻度AP,而14例患者(35%)患有中度重症胰腺炎;然而,3例患者(7.5%)患有重度AP。
我们发现儿童胰腺炎大多病情较轻,病因与成人有很大不同,而且大多数急性复发性胰腺炎病例都有明确的病因,即基因突变或结构异常。