Background: The purpose of this study was to analyze the characteristics of the clinical presentations, etiologies, diagnoses, and treatment of pediatric pancreatitis in southern Taiwan.
Methods: Sixty-one patients, ranging in age from 2 to 18 years (mean, 8.8+/-4.8 years old), with diagnoses of pancreatitis were studied from July 1986 through June 2000.
Results: Twenty-eight pancreatitis cases resulted from physical trauma, 13 cases of which were from traffic accident (53.8% from motorcycle accident). Other pathogenic factors included systemic diseases (N=9), pancreaticobiliary-tree anomalies (N=7), toxin ingestion or drug use (N=4), Ascaris infection (N=1), and idiopathic (N=12). Symptoms included abdominal pain (N=58), vomiting (N=23), fever (N=18), and jaundice (N=2). Hyperamylasemia was found in 51 children (83.6%). Twenty-seven patients (90.0%) had elevated serum lipase levels (>190 U/L) of 30 evaluated. The amylase to creatinine clearance ratio was assayed for 35 cases, of which 28 (80.0%) were elevated (>6%). Ultrasonography revealed inflammatory changes of the pancreas in 40 of 51 patients evaluated, while computed tomogram demonstrated evidence of pancreatic inflammation for all 21 patients evaluated. Fifteen cases required surgery, while the other 46 were managed conservatively. One patient died because of acute necrotizing pancreatitis 3 days after L-asparaginase treatment for leukemia. The other patients survived well during long-term follow up.
Conclusion: Pancreatitis in children is more common than generally believed. Physical trauma, especially because of motorcycle accidents, was the leading cause of pediatric pancreatitis in southern Taiwan. The mortality rate was low. Only one patient who had undergone chemotherapy with L-asparaginase died of the disease.