Pancreatitis in children: Experience in a tertiary care medical college hospital

Background: Acute, acute recurrent and chronic pancreatitis cause significant health problems in the paediatric population. In view of the small number of patients, it is difficult to evaluate outcomes, genetic causes, treatments, prognostic indicators, severity, and epidemiologic factors in childhood in a prospective way. Objectives: To determine the characteristics of patients with pancreatitis (acute, chronic and recurrent) presenting to us. Method: This was a retrospective descriptive study of consecutive paediatric patients admitted between January 2017 and December 2020 (4 years) in our paediatric department with a diagnosis of pancreatitis. Patient characteristics, laboratory and imaging results, identified aetiology of pancreatitis, and recurrence rates were recorded and evaluated.Results: There were 34 visits, of which 28 were for acute pancreatitis (including 3 with acute on chronic pancreatitis), and 6 for an episode of recurrent pancreatitis. The median age for all visits was 9 years (range 2-16). Of the acute cases, 14 had uncertain or undetermined aetiologies, 3 had systemic diseases, 2 were associated with medications, most common being valproic acid, 3 were cholelithiasis-related, 5 were due to other infections and one was due to trauma; one child with 3 recurrent episodes was suspected to have a genetic basis and 1 child was diagnosed to have Rapunzel syndrome (trichobezoar). There were five patients with chronic pancreatitis, of which 3 had acute on chronic pancreatitis.Conclusions: Abdominal pain, nausea, vomiting, fever and jaundice were the common clinical presentations of acute pancreatitis in children. The common aetiological factors identified were infections (18%), systemic illness (11%), drug induced (7%) and obstructive/ cholelithiasis (7%); in 46% the aetiology was unknown.