Alta frecuencia de pancreatitis aguda asociada a patología biliar en niños chilenos

Abstract

Acute Pancreatitis (AP) in children presents significant morbimortality. Most common etiologies in this age group are trauma, systemic illness and idiopathic pancreatitis. This is different from adult AP, where lithiasis and alcohol consumption are the predominant causes. In Chile, where billiary disease is highly prevalent, there is little information regarding AP among children. Objective: To determine the main clinical characteristics of acute pancreatitis in a group of chilean children. Patients and Methods: A retrospective study (1998-2008) of patients hospitalized with the diagnosis of AP. The diagnosis was confirmed by elevation of pancreatic enzymes and through images. Demographic data, etiology, complications and resolutions, need for parenteral nutrition, and use of antibiotics were examined. Results: Eighteen patients were identified (8,3 ± 4 y.o.). Etiology of AP was listed as: lithiasis and alterations of biliary duct: 38,8%, idiopathic: 22,2%, secondary to medications: 22,2% and other: 16.8%. Two patients presented peripancreatic infected collections; a similar number formed pancreatic pseudocysts. Six patients (33,3%) required one type of surgical procedure as part of their treatment. Two-thirds of all patients required treatment in ICU. One half of the patients required parenteral nutrition, and two thirds received IV antibiotics. The median length of hospital stay was 20 days (ave 24,9 ± 14,3 ds). There was no mortality in this serie. Conclusions: Unlike previously described, biliary AP was the most common cause in this serie. Biliary pathology should be actively studied among chilean children with AP.