Acute pancreatitis in children: a 15-year review

J Pediatr Surg. 1994 Jun;29(6):719-22. doi: 10.1016/0022-3468(94)90353-0.

Abstract

Aim: To review the aetiology, presentation, diagnosis, management, and sequelae of acute pancreatitis (AP) in children and to assess the relevance of prognostic criteria used to assess severity in adult AP.

Method: A retrospective review (1978 through 1992) of childhood AP managed in three Scottish paediatric centres.

Results: Forty-nine cases of AP (34 male, 15 female) were reviewed (mean age, 7.1 years). The presenting features were abdominal pain and vomiting (80%), abdominal tenderness (73%), and parotid enlargement (22%); back pain was rare (8%). Ultrasound scan (US) findings were abnormal for 24 of 34 patients. Forty-one (82%) were managed conservatively. Six (12%) underwent early laparotomy; three (6%) underwent laparotomy after trauma. Five required subsequent definitive surgery. One patient died. Thirty-five (70%) suffered no sequelae, and five (10%) had further acute pancreatitis. Only half of the eight Imrie prognostic criteria had been recorded in these patients; only three were judged to have severe AP by the criteria. Other "clinically severe" cases were not identified.

Conclusion: The most common causes of AP were mumps (39%) and trauma (14%); in 12, no cause was identified. US was the most useful imaging tool. The Imrie criteria were of doubtful value but warrant further prospective analysis and possible modification for children.

MeSH terms

  • Acute Disease
  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Pancreatitis* / complications
  • Pancreatitis* / diagnosis
  • Pancreatitis* / etiology
  • Pancreatitis* / therapy
  • Prognosis
  • Retrospective Studies