Acute Necrotizing Pancreatitis in Children

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• 作者：Aileen Raizner ; MD¹ ; Uma Padhye Phatak ; MD¹ ; Kenneth Baker ; MD² ; Mohini G. Patel ; MD¹ ; Sohail Z. Husain ; MD³ ; Dinesh S. Pashankar ; MD¹ ; ^{dinesh.pashankar@yale.edu}
• 关键词：CT ; Computed tomography
• 刊名：The Journal of Pediatrics
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：162
• 期：4
• 页码：788-792
• 全文大小：320 K

文摘

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Objective

To describe the etiologic factors, course, and outcome of acute necrotizing pancreatitis in children.

Study design

We performed a retrospective study of children with necrotizing pancreatitis diagnosed during the last 21 years at Yale-New Haven Children¡¯s Hospital. Computed tomography (CT) criteria were used to diagnose necrotizing pancreatitis and to assess severity index. Charts were reviewed to collect demographics, etiology, details of hospital stay, complications, and outcome.

Results

Seven children (mean age, 11.6 years; range, 4-17.8 years) had necrotizing pancreatitis. Etiologic factors were medications, diabetes, and gallstones. All had prolonged hospitalization (9-40 days; mean, 20 days) and 5 patients required admission to the pediatric intensive care unit. During the hospital stay, patients developed complications involving the respiratory, hematologic, renal, metabolic, and circulatory systems. All patients had aggressive supportive medical therapy, and none required surgery. There were no deaths attributable to pancreatitis. Late complications after hospital discharge occurred in 5 patients and included pseudocysts, transient hyperglycemia, diabetes, and pancreatic exocrine insufficiency. The CT severity index correlated with the risk of complications.

Conclusions

A cute necrotizing pancreatitis has a variable etiology in children. CT scan is useful in the diagnosis and assessment of severity. Necrotizing pancreatitis in children is associated with severe acute and late complications and requires intensive medical therapy.