Acute, acute recurrent and chronic pancreatitis: an exploration of clinical and etiologic factors and outcomes

ESPGHAN 54th Annual Meeting, Kobenhavn, Danimarka, 22 - 25 Haziran 2022, cilt.74, ss.231

GASTROENTEROLOGY - Cystic fibrosis and pancreatic disorders

G-P-095

Acute, acute recurrent and chronic pancreatitis: an exploration of clinical and etiologic factors

and outcomes

Y. Aydemir1, M. Yagci2, Z. Baris1

1Eskisehir Osmangazi University, Pediatric Gastroenterology and Hepatology, Eskisehir,

Turkey, 2Eskisehir Osmangazi University, Pediatrics, Eskisehir, Turkey

Objectives and Study: We aimed to analyze clinical, laboratory, and imaging findings, etiologies and

outcomes of children with pancreatitis.

Methods: This study was conducted between Jannuary 2011 and October 2021. Demographics,

history of medication, trauma and infection, presenting symptoms, clinical findings, laboratory results,

imaging findings, genetic studies, treatment modality, and outcomes were obtained from medical

records. International study group of pediatric pancreatitis: in search for a cure criteria were used to

define acute (AP), acute recurrent (ARP) and chronic pancreatitis (CP).

Results: During the study period, 75 children (41 girls, mean age 11.5±4.3 years) with pancreatitis

included in the study. There were 46 (61.3%) patients with AP and 29 (38.7%) with recurrent

pancreatitis [21 (28%) with ARP and 8 (10.7%) with CP]. Trauma was the most prevalent (20%) cause

in patients with AP, followed by viral infection (12%), medications (10.7%), biliary disease

(gallstones/sludge) (9.3%). Of the 29 patients with recurrent pancreatitis (ARP and CP), 8 (27.6%)

were found to have underlying genetic etiologies (5 with PRSS1, 2 with SPINK1 and 1 with CTRC), 5

(17.2%) were found to have pancreatic divisium, 2 (6.9%) with pancreatobiliary junction anomaly and 1

(3.4%) with hypertriglyceridemia. Etiological factor could not be identified in 16/46 patients with AP and

13/29 patients with ARP and CP. Pancreatic necrosis were seen in 2 (2.7%) and pancreatic pseudo

cyst in 9 (12%). Endoscopic retrograde cholangiopancreatography was necessary in 10 patients while

surgical management only in 1 patient. ERCP was performed after extracorporeal shock wave

lithotripsy in a patient with chronic pancreatitis who had a stone in the pancreatic duct. The mortality

rate was 2.7% (causes were trauma and leukemia), it was not attributable to pancreatitis in both of the

cases.

Conclusions: Acute, acute recurrent, and chronic forms of pancreatitis have been increasingly

diagnosed in children in the past two decades. Although, the etiology could be identified in most of the

children with advance genetic and metabolic screening, it remains undetermined in approximately one

third of the patients.