Clinical characteristics and prognosis of acute pancreatitis in children

Abstract:

Objective To study the clinical characteristics of acute pancreatitis (AP) in children.Methods A retrospective analysis was conducted on the children with AP who were hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2022, and their clinical characteristics were summarized and analyzed.Results A total of 92 children with AP were included, with a male/female ratio of 1:1 and a mean age of (9±4) years. Adolescents (34%, 31/92) and pre-school children (33%, 30/92) were more commonly affected, while infants and toddlers (7%, 6/92) were less commonly affected. The etiology of the disease from most to least was as follows: drug-induced (40%, 37/92), biliary (18%, 17/92), dietary (14%, 13/92), idiopathic (13%, 12/92), trauma-related (9%, 8/92), and infectious (5%, 5/92). Mild, moderate, and severe AP accounted for 68% (63/92), 21% (19/92), and 11% (10/92), respectively. Among all 92 children, 62 (67%) received abdominal ultrasound, with a positive rate of 66% (41/62); 67 (73%) underwent abdominal CT, with a positive rate of 90% (60/67); 20 (22%) underwent magnetic resonance cholangiopancreatography (MRCP), with a positive rate of 95% (19/20). There were significant differences in the levels of D-dimer, procalcitonin, and amylase among children with different degrees of severity of the condition (P<0.05), and there were significant differences in the levels of leukocyte count, hematocrit, blood urea nitrogen, albumin, and blood calcium among children with different etiologies (P<0.05). Of all 92 children, 89 (97%) had a good prognosis.Conclusions The primary cause of pediatric AP is medication-induced, with a predominantce of mild cases. Abdominal CT has a high rate of utilization and positivity in the diagnosis of pediatric AP, while MRCP has the highest specificity among imaging techniques. Laboratory tests aid in determining the severity and etiology of AP. The prognosis of AP is favorable in children.