Subject(s)
Endosonography , Heart Neoplasms , Myxoma , Neuroendocrine Tumors , Pancreatic Neoplasms , Adult , Computed Tomography Angiography , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Heart Atria/diagnostic imaging , Heart Atria/surgery , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/surgery , Humans , Male , Myxoma/diagnostic imaging , Myxoma/surgery , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/pathology , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathologySubject(s)
Pancreatitis/etiology , Acute Disease , Celiac Disease/complications , Celiac Disease/epidemiology , Dissent and Disputes , Female , Humans , Hyperthyroidism/complications , Hyperthyroidism/epidemiology , Hypertriglyceridemia/complications , Hypertriglyceridemia/epidemiology , Pancreas/abnormalities , Pancreatitis/epidemiology , Pancreatitis/genetics , Pancreatitis, Alcoholic/complications , Pancreatitis, Alcoholic/epidemiology , Pancreatitis, Alcoholic/etiology , Pregnancy , Pregnancy Complications/epidemiologyABSTRACT
BACKGROUND: Acute pancreatitis is a painful inflammatory disorder known to occur in children. Recent reports, primarily on the basis of adult data, have suggested an increasing incidence. However, pediatric studies are limited. OBJECTIVE: The study was performed to examine the frequency of acute pancreatitis in a pediatric population from 1994 to 2007 and to characterize etiologies by age subsets. PATIENTS AND METHODS: In this retrospective study, cases of pancreatitis were identified by ICD-9 codes and subjected to inclusion criteria. RESULTS: Two hundred and seventy-one cases of pancreatitis met inclusion criteria. Mean age of the subjects was 13.1 +/- 5.6 years. The recurrence rate was 15.3%. Biliary disease was the most common etiology (32.6%). Acute pancreatitis cases evaluated at a single tertiary care center increased 53% between 1995 to 2000 and 2001 to 2006 (P < 0.02). However, when cases were normalized by all annual pediatric emergency department visits for all medical reasons, the increase was reduced to 22% and lost statistical significance (P = 0.16). The rise was not associated with a change in etiologies or body mass index (BMI). CONCLUSIONS: This is the first report demonstrating that an increase in pediatric pancreatitis may in part be due to growing referrals to tertiary care centers. The data on etiologies, particularly with regard to differing ages, may be helpful in managing children who present with acute pancreatitis.
Subject(s)
Biliary Tract Diseases/complications , Pancreatitis/epidemiology , Referral and Consultation/trends , Adolescent , Child , Female , Humans , Incidence , Male , Pancreatitis/etiology , Recurrence , Retrospective Studies , Sex DistributionABSTRACT
Hypercalcemia is an important etiology to consider in the evaluation of acute pancreatitis. Not only is it a treatable cause, but understanding the basis for this etiology may provide new insight into the common biochemical mechanisms involved in the pathogenesis of pancreatitis. We report a case of an 11-year-old girl with hypercalcemia due to primary hyperparathyroidism who developed recurrent pancreatitis. We review clinical and experimental data that implicate hypercalcemia as the cause and discuss mechanisms for the association.
