On the issue of acute pancreatitis in children
DOI:
https://doi.org/10.15574/PP.2023.93.98Keywords:
pancreas, children, pancreatitis, etiology, diagnosisAbstract
Purpose - to analyze modern approaches to understanding classification, etiopathogenesis, principles of diagnosis of pancreatitis in children.
The pancreas has an important role in the processes of adequate digestion and assimilation of nutrients, as it ensures the fermentation of proteins, fats, and carbohydrates. The problem of pancreatitis in pediatrics worries not only domestic specialists, it is extremely important for study by the medical community in the world. Experts of the European Pancreatic Club focused on the fact that the incidence of acute pancreatitis has increased over the last 10-15 years and is 3.6-13.3 cases per 100,000 children. Taking into account such statistics, acute pancreatitis leaves the rubric of rare diseases, as it approaches the frequency in adults. It is important to understand the leading etiological factors of pancreatitis in childhood, as they are not identical to those in adult patients. However, the etiological factors in children are not of the same type according to the data of various studies. For example, according to the results of a twelve-year research in the USA, the dominant causes of pancreatitis in children were biliary tract problems (36.2%) and drug use (25.6%). Among sick children living in India, the causes were mostly injuries (21%) and biliary pathology. One of the latest data obtained in the study of children in the USA shows the structure of etiological factors: idiopathic (31%) and the influence of medications (23%). Analysis of the clinical course of the first episode of pancreatitis in children revealed that age, male gender, pancreatic necrosis and a higher body mass index were associated with the formation of a recurrent course. However, it is necessary to take into account possible anatomical anomalies of the biliary tract, hyperlipidemia and genetic factors. Modern guidelines and clinical recommendations for the diagnosis of pancreatitis in children mostly coincide and suggest taking into account the existing clinical symptoms and their consistency with the data of additional research methods.
No conflict of interests was declared by the author.
References
Abu-El-Haija M, Kumar S, Quiros JA et al. (2018). Management of acute pancreatitis in the pediatric population: a clinical report from the North American society for pediatric gastroenterology, hepatology and nutrition pancreas committee. J Pediatr Gastroenterol Nutr. 66 (1): 159-176. https://doi.org/10.1097/MPG.0000000000001715; PMid:29280782 PMCid:PMC5755713
Abu-El-Haija M, Valencia CA, Hornung L et al. (2019). Genetic variants in acute, acute recurrent and chronic pancreatitis affect the progression of disease in children. Pancreatology. 19 (4): 535. https://doi.org/10.1016/j.pan.2019.05.001; PMid:31088717 PMCid:PMC6589390
Alabdulkareem A, Almahmoud T, Al-Tahan H et al. (2018). Etiology and clinical characteristics of pediatric acute pancreatitis in Saudi Arabia: a 20-year experience from a single tertiary center. Int J Pediatr Adolesc Med. 5 (1): 13-17. https://doi.org/10.1016/j.ijpam.2018.01.001; PMid:30805526 PMCid:PMC6363251
Aune D, Mahamat-Saleh Y, Norat T et al. (2019). Tobacco smoking and the risk of pancreatitis: A systematic review and meta-analysis of prospective studies. Pancreatology. 19: 1009-1022. https://doi.org/10.1016/j.pan.2019.09.004; PMid:31668562
Banadyga A, Banadyha N, Banadyga S (2010). Early diagnosis and prevention of complications of acute pancreatitis. Journal of Education, Health and Sport Journal of Education, Health and Sport. 10 (2): 74-78. https://doi.org/10.12775/JEHS.2020.10.02.010
Banadyha NV. (2008). Diagnosis of secondary disorders of the exocrine function of the pancreas in children. Sovremennaya pediatriya. 4 (21): 92-94
Gariepy CE, Heyman MB, Lowe ME et al. (2017). Causal Evaluation of Acute Recurrent and Chronic Pancreatitis in Children: Consensus From the INSPPIRE Group. J Pediatr Gastroenterol Nutr. 64 (1): 95-103. https://doi.org/10.1097/MPG.0000000000001446; PMid:27782962 PMCid:PMC5191966
Grzybowska-Chlebowczyk U, Jasielska M, Flak-Wancerz A et al. (2018). Acute pancreatitis in children. Prz Gastroenterol. 13 (1): 69-75. https://doi.org/10.5114/pg.2017.70470; PMid:29657614 PMCid:PMC5894443
Jalaly NY, Moran RA, Fargahi F et al. (2017). An Evaluation of Factors Associated With Pathogenic PRSS1, SPINK1, CTFR, and/or CTRC Genetic Variants in Patients With Idiopathic Pancreatitis. Am J Gastroenterol. 112: 1320-1329. https://doi.org/10.1038/ajg.2017.106; PMid:28440306
Khan A, Vege SS, Vikas Dudeja V et al. (2022). Staging exocrine pancreatic dysfunction. Pancreatology. 22 (1): 168-172. https://doi.org/10.1016/j.pan.2021.11.005; PMid:34916141
Kumar S, Ooi CY, Werlin S et al. (2016). Risk Factors Associated With Pediatric Acute Recurrent and Chronic Pancreatitis: Lessons From INSPPIRE. JAMA Pediatr. 170: 562. https://doi.org/10.1001/jamapediatrics.2015.4955; PMid:27064572 PMCid:PMC5317277
Lin TK, Troendle DM, Wallihan DB et al. (2017). Specialized Imaging and Procedures in Pediatric Pancreatology: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Clinical Report. J Pediatr Gastroenterol Nutr. 64 (3): 472-484. https://doi.org/10.1097/MPG.0000000000001371; PMid:28230608
Martin CR, Cheesman A, Brown J et al. (2016). Factors determining optimal fatty acid absorption in preterm infants. J Pediatr Gastroenterol Nutr. 62: 130-136. https://doi.org/10.1097/MPG.0000000000000934; PMid:26252920 PMCid:PMC4691401
Morinville VD, Husain SZ, Bai H et al. (2021). Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 55 (3): 261-265. https://doi.org/10.1097/MPG.0b013e31824f1516; PMid:22357117 PMCid:PMC3626452
Morinville VD, Lowe ME, Ahuja M et al. (2014). Design and implementation of INSPPIRE J Pediatr Gastroenterol Nutr. 59 (3): 360-364. https://doi.org/10.1097/MPG.0000000000000417; PMid:24824361 PMCid:PMC4141003
Nguyen THL, Yeung KA, Pugmire B, Gugig R. (2020). Pancreatitis. Pediatr Rev. 41 (10): 511-521. URL: https://publications.aap.org/pediatricsinreview/article-abstract/41/10/511/35346/Pancreatitis?redirectedFrom=fulltext. https://doi.org/10.1542/pir.2018-0252; PMid:33004663
NICE (2018). Guidelines: Pancreatitis. Published Sept 2018. URL: https://www.bsg.org.uk/clinical-resource/nice-guidelines-pancreatitis/.
Pant C, Sferra TJ, Lee BR. (2016). Acute recurrent pancreatitis in children: a study from the pediatric health information system. J Pediatr Gastroenterol Nutr. 62 (3): 450-452. https://doi.org/10.1097/MPG.0000000000001058; PMid:26704865
Park A, Latif SU, Shah AU et al. (2009). Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis. J Pediatr Gastroenterol Nutr. 49 (3): 316-322. https://doi.org/10.1097/MPG.0b013e31818d7db3; PMid:19503003 PMCid:PMC3034387
Párniczky A, Abu-El-Haija M, Husain S et al. (2018, Mar). EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis. Pancreatology. 18 (2): 146-160. https://doi.org/10.1016/j.pan.2018.01.001; PMid:29398347
Patel N , Sellers ZM, Grover A et al. (2021). Endoscopic Pancreatic Function Testing (ePFT) in Children: A Position Paper From the NASPGHAN Pancreas Committee. Journal of Pediatric Gastroenterology and Nutrition. 72; 1: 144-150. https://doi.org/10.1097/MPG.0000000000002931; PMid:32910088
Poddar U, Yachha SK, Borkar V. (2017). A report of 320 cases of childhood pancreatitis: increasing incidence, etiologic categorization, dynamics, severity assessment, and outcome. Pancreas. 46 (1): 110-115. https://doi.org/10.1097/MPA.0000000000000733; PMid:27846143
Rompianesi G, Hann A, Komolafe O et al. (2017, Apr 21). Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis.Cochrane Database Syst Rev. 4 (4): CD012010. https://doi.org/10.1002/14651858.CD012010.pub2; PMid:28431198 PMCid:PMC6478262
Struyvenberg MR, Martin CR, Freedman SD. (2017). Practical guide to exocrine pancreatic insufficiency - Breaking the myths. BMC Medicine. 15: 29. https://doi.org/10.1186/s12916-017-0783-y; PMid:28183317 PMCid:PMC5301368
Sweeny KF, Lin TK, Nathan JD et al. (2019). Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 68 (1): 104-109. https://doi.org/10.1097/MPG.0000000000002145; PMid:30234758 PMCid:PMC6310081
Uc A, Husain SZ. (2019). Pancreatitis in children. Gastroenterology. 156 (7): 1969-1978. https://doi.org/10.1053/j.gastro.2018.12.043; PMid:30716320 PMCid:PMC6730664
Vege SS. (2022). Etiology of acute pancreatitis. UpToDate Apr 27, 2022. URL: https://www.uptodate.com/contents/etiology-of-acute-pancreatitis?source=mostViewed_widget#H12.
Wolfe D, Kanji S, Yazdi F et al. (2020). Drug induced pancreatitis: A systematic review of case reports to determine potential drug associations. PLoS One. 15: e0231883. https://doi.org/10.1371/journal.pone.0231883; PMid:32302358 PMCid:PMC7164626
Xu T, Liu J, Liu J et al. (2017). Relation between metabolic syndrome and body compositions among Chinese adolescents and adults from a large-scale population survey. BMC Public Health. 17: 1. https://doi.org/10.1186/s12889-017-4238-3; PMid:28427375 PMCid:PMC5397692
Zhong R, Tan S, Peng Y et al. (2021). Clinical characteristics of acute pancreatitis in children: a single-center experience in Western China. BMC Gastroenterology. 21: 116. https://doi.org/10.1186/s12876-021-01706-8; PMid:33750293 PMCid:PMC7941124
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