Mathew P, Wyllie R, Caulfield M, Steffen R, Kay M
Department of Pediatrics, Cleveland Clinic Foundation, OH 44195.
Clin Pediatr (Phila). 1994 Feb;33(2):88-94. doi: 10.1177/000992289403300205.
Acute pancreatitis is unusual in pediatric patients, and chronic pancreatitis is even less common. Between 1983 and 1988, we diagnosed 24 patients in late childhood and adolescence with chronic pancreatitis. Our review revealed that chronic pancreatitis presents as recurrent abdominal pain in late childhood and adolescence. Individual laboratory and radiological investigations may be normal during acute exacerbations of pain, but the determination of serum amylase and lipase concentrations--combined with ultrasonography--will accurately identify most patients. We found that endoscopic retrograde cholangiopancreatography is a valuable tool in the diagnosis of structural abnormalities. Surgical intervention may reduce symptoms in patients with structural abnormalities. There is a tendency toward decreased frequency and severity of pain as the patients increase in age.
急性胰腺炎在儿科患者中并不常见，而慢性胰腺炎则更为罕见。1983年至1988年间，我们诊断出24例儿童晚期和青少年慢性胰腺炎患者。我们的回顾发现，慢性胰腺炎在儿童晚期和青少年期表现为反复腹痛。在疼痛急性发作期间，个别实验室检查和影像学检查可能正常，但血清淀粉酶和脂肪酶浓度的测定——结合超声检查——将准确识别大多数患者。我们发现内镜逆行胰胆管造影术是诊断结构异常的一项有价值的工具。手术干预可能会减轻有结构异常患者的症状。随着患者年龄增长，疼痛发作频率和严重程度有降低的趋势。
