Clinical characteristics of 88 cases of acute pancreatitis in children of different age

Abstract

Objective To investigate the clinical features of acute pancreatitis (AP) in children of different age. Methods From January 2010 to December 2015, pediatric inpatients with AP were searched by pediatric inpatient medical records retrieval system. According to age, patients were divided into three groups: infant and toddler group (age 0 years to three years), preschool group (age >three years to six years) and school-aged group (age >six years to 16 years). The clinical features, etiology and laboratory findings of different age groups were retrospectively analyzed. One-way analysis of variation or rank sum test was performed for measurement data analysis. Chi-square test or Fisher exact probability test was used for the count data analysis. Results A total of 88 pediatric patients (male 38, female 50) were enrolled, and the mean age was (8.8±4.4) years. Infant and toddler group, preschool group and school-aged group were 16, 14, 58 cases, respectively. The average days of hospitalization of infant and toddler group, preschool group and school-aged group were (8.4±1.9), (9.4±2.6) and (7.5±2.5) days, respectively, and the difference was statistically significant (F=3.649, P=0.030). About 93.2% (82/88) pediatric patients had abdominal pain. The incidence rate of epigastric distention of school-aged group (34.5%, 20/58) was higher than those of infant and toddler group (2/16) and preschool-aged group (1/14). The rate of nausea/vomiting of infant and toddler group was significantly higher than those of preschool group and school-aged group (12/16, 4/14 and 46.6% (27/58), respectively), and the differences were both statistically significant (χ2=6.250 and 6.805, both P 0.05). The percentage of obese children of school-aged group was significantly higher than those of infant and toddler group and preschool group (31.0%, 18/58; 1/16 and 1/14, respectively), and the difference was statistically significant (χ2=6.689, P=0.035). In addition, the level of serum total cholesterol of school-aged group was higher than that of infant and toddler group and preschool group ((5.1±0.9), (3.9±0.6) and (4.8±0.8) mmol/L, respectively), and the difference was statistically significant(F=13.855, P<0.01). The positive rates of abdominal ultrasound of infant and toddler group, preschool group and school-aged group were 5/16, 4/14 and 21.1%(12/57), respectively, and there was no statistically significant difference (χ2=0.889, P=0.706). The positive rates of magnetic resonance cholangiopancreatography (MRCP) of infant and toddler group and school-aged group were 4/4 and 5/6, respectively, and which were both higher than those of pancreases computed tomography (CT) examination (4/14 and 51.2%, 22/43) and those of abdominal ultrasound (5/16 and 21.1%, 12/57), and the differences were significant (χ2=6.655 and 15.207, both P<0.05). Conclusions Obese children is more in school-aged children with AP. Children of this age should pay more attention to life style. Nausea or vomiting symptom is more obvious in the infant and toddler children with AP and the condition is more severe. If children of this age with unexplainable vomiting, AP should be considered. Biliary factors are more common in the infant and toddler children with AP. When children are suspected with abnormal structure of pancreatic and biliary ductal system, MRCP should be conducted. Key words: Acute pancreatitis; Clinical characteristics; Etiologies; Children