Table 1 Acute pancreatitis - 85 cases
From: Pancreatitis in pre-adolescent children: a 10 year experience in the pediatric emergency department
Etiology | # | Age in yrs Median (IQR/range) | BMI Median (IQR) | Lipase in U/L Median (IQR) | Presumed etiology or Associations | Identified recurrences |
|---|---|---|---|---|---|---|
Uncertain - 22 (26%) | ||||||
Idiopathic | 13 | 8 (5.5–10.5 / 1–11) | 16.3 (14.6–18.8) | 736 (387–888) | – | 1 pt. w/hx chronic constipation had 2 recurrences |
Possibly Infectious | 9 | 3 (2–10 / 0.9–12) | 20.4 (16–20.9) | 450 (160–1062) | All thought to be viral related | – |
Systemic - 17 (20%) | ||||||
Associated Acute Systemic | 10 | 6.5 (5–11.25 / 1–12) | 16.8 (14.2–22.4) | 670 (205–1468) | 3 pts. DKA 2 pts. Kawasaki’s disease 1 pt. HUS 1 pt. ATN 1 pt. Takayasu’s arteritis 1 pt. AKI/DI 1 pt. new Leukemia | – |
Associated Chronic Systemic | 7 | 7 (3–12 / 2–12) | 16.1 (13.4–18.7) | 773 (292–1891) | 3 pts. Celiac disease 1 pt. Lupus 1 pt. Hypothyroidism 1 pt. Ulcerative colitis 1 pt. Crohn’s | 1 pt. w/celiac disease had 2 recurrenced |
Medications - 16 (19%) | ||||||
Valproic Acid | 7 | 9 (8–12 / 6–12) | 21.7 (18.7–25.2) | 893 (589–1200 | – | – |
Chemotherapy | 4 | 8.5 (4.25–9.75 / 3–10) | 22.6 (16–28) | 1717 (800–8296) | 3 pts. on pegaspargase 1 pt. on pentamadine | 1 pt. on pegaspargase had 3 recurrences |
Oxcarbazepine | 1 | 9 | 18.5 | 1644 | – | – |
Metronidazole | 1 | 5 | 12.4 | 2064 | – | – |
Erythromycin | 1 | 12 | “Under- weight” | 176 | – | – |
Chlorothiazide | 1 | 1 | 21 | 182 | – | – |
TPN | 1 | 0.5 | 17.9 | 265 | – | – |
Cholelithiasis - 14 (16%) | ||||||
No past history of gallstones | 11 | 9 (5–11 / 2–12) | 26.5 (18.1–33.2) | 1954 (1391–3473) | – | 3 pts. w/1 recurrence each |
Known history of gallstones | 3 | 12 (10–12 / 10–12) | 29 (19.7–45) | 437 (137–1444) | – | 1 pt. w/1 recurrence |
Structural - 7 (8%) | ||||||
Choledochal Cyst | 5 | 4 (2.5–4.5 / 2–5) | 16.6 (15–20.3) | 1702 (527–9550) | – | – |
Caroli disease | 1 | 1 | 23.6 | 1683 | congenital abnormality of common bile duct | 2 recurrences |
Pancreatic Duct Stricture | 1 | 4 | 17 | 3283 | – | 4 recurrences |
Genetic - 6 (7%) | ||||||
Propionic Acidemia | 3 | 7 (6–12 / 6–12) | 18.3 (14.2–22.4) | 2262 (1327–3292) | – | – |
Hennekam syndrome | 1 | 11 | 13.1 | 197 | Pt with Hennekam syndrome and on TPN | 1 recurrence |
CTRC mutation | 1 | 5 | 13.7 | 2000 | – | 1 recurrence |
Heterozygous Cystic Fibrosis | 1 | 9 | 23.6 | 290 | – | 1 recurrence |
Post-operative - 3 (4%) | ||||||
s/p Appendectomy | 1 | 9 | 19 | 189 | s/p appendectomy, had intra-abd. abscess & lipase was elevated | |
s/p Spinal Fusion surgery | 1 | 8 | * | 178 | s/p spinal surgery, abd.pain and emesis, lipase found elevated | 2 recurrences |
s/p ERCP | 1 | 11 | 18 | 651 | ||