Aetiology and clinical characteristics of first episode of acute pancreatitis in children

Aim of the study
Although the recognition of acute pancreatitis in children has been increasing over the last decades, knowledge this condition is limited. Thus, we aimed to evaluate the aetiology and clinical course of the first episode of acute pancreatitis in children.

Material and methods
We retrospectively analysed medical records of patients hospitalized due to the first episode of acute pancreatitis in the Department of Paediatrics and Gastroenterology, Medical University of Lublin, from January 2011 to December 2019. The analysis took into account the age and sex of patients, clini­cal symptoms, abnormalities in physical examination, past and family history data, and results of laboratory and imaging tests. The review of consecutive hospitalizations of patients from the study group was carried out to assess the number of recurrences of pancreatitis in the analysed period.

Results
The study group consisted of 72 patients, including 37 boys and 35 girls. The age of patients ranged from 2 to 18 years, with a median of 12 years. The vast majority (62%) of acute pancreatitis cases were diagnosed in the latter 4 years of the study period. In 43% of patients, acute pancreatitis was of idiopathic origin, followed by infectious (22%), toxic (18%), and biliary (8%) aetiology. The most common initial symptoms included abdominal pain (93%), vomiting (66%), and nausea (28%). In the study period recurrence of acute pancreatitis occurred in one-third of the children.

Conclusions
Paediatric acute pancreatitis is an increasing health care issue with various aetiologies. Acute pancreatitis should be considered in every child with acute abdominal pain, vomiting, or nausea. Further studies are needed to determine the risk factors of recurrent acute pancreatitis.