Acute pancreatitis in childhood: analysis of literature data

GOALS: To review the published experience with acute pancreatitis in childhood. STUDY: Computerized search of the English medical literature since 1965 using MEDLINE. RESULTS: Details of 589 patients were reviewed. Mean age was 9.2 +/- 2.4 years (range: 1 week to 21 years). Male to female ratio was 1.2. Etiologies included (n = 589): idiopathic (23%), trauma (22%), structural anomalies (15%), multisystem disease (14%), drugs and toxins (12%), viral infections (10%), hereditary (2%) and metabolic disorders (2%). Diagnosis was based most often on abnormal abdominal ultrasonography (81%) and on elevated serum amylase levels (63%). Radiograph findings were helpful in 34%. In 16% of the patients the diagnosis was based only on laparotomy. Mean hospital stay was 13.2 +/- 2.4 days and TPN was required in 28% of the patients. In 24% of the subjects a surgical intervention was indicated. Recurrence was reported in 9%, most of them with idiopathic and structural etiologies. Fatal outcome was described in 9.7% of the patients. CONCLUSIONS: Acute pancreatitis of childhood, although considered sometimes as a minor disorder, carries significant morbidity and mortality. Therefore, pediatricians should be more aware of this illness.