Acute Pancreatitis in 106 Children / 实用儿科临床杂志

ABSTRACT

Objective To understand the clinical features of children with acute pancreatitis.Method Clinical data of 106 in patients in Children′s Hospital with acute pancreatitis from Jul.1991 to Jan.2005 were analyzed retrospectively.Results The most frequent(etiologic) factors of childhood acute pancreatitis were idiopathic(35.8%),mumps virus infection(33.9%)and biliary tract diseases(15%).Abdominal pain(96.2%),vomiting(72.6%)and fever(45.3%) were the most common clinical symptoms.And the most common signs were abdominal tenderness(73.6%),abdominal wall rigidity(17.9%)and abdominal distention(10.6%).Multisystem damage usually occurred in childhood acute pancreatitis.Serum amylase,urinary amylase and serum lipase elevated 84.8%,58.5% and 55%in patients,respectively.Fifty-one percont patients had abnormal ultrasound imaging and 81% had abnormal computed tomographic imaging.In 5 patients who were subjected to endoscopic retrograde cholangiopancreatography(ERCP) and magnetic resonance cholangiopancreatography(MRCP),the pancreaticobiliary system was visualized clearly.Nonsurgical therapy was done in most patients,only 6 cases received surgical therapy.Sixty-five cases were cured and 40 cases straightened up,only 1 case died.The efficiency rate was 99%.Pseudocysts occurred in 2 patients.Conclusions Idiopathic pancreatitis and mumps virus infection are the most frequent etiologic factors for childhood acute pancreatitis.Symptoms and signs such as abdominal pain and abdominal tenderness are the important diagnostic bases of childhood acute pancreatitis.Childhood acute pancreatitis was always accompanied by multisystem damage.Pancreatic enzyme test and radiography test were helpful in the diagnosis of childhood acute pancreatitis.Nonsurgical therapy is the leading therapeutic means of childhood acute pancreatitis.Timely diagnosis and allopathy help to improve the prognosis of childhood acute pancreatitis.Pseudocyst is the primary complication of childhood acute pancreatitis.