NADIRA MUSABBIR1, ASM BAZLUL KARIM2, MD. WAHIDUZZAMAN MAZUMDER3, KANIZ SULTANA4,SYEDA AFRIA ANWAR5, MD. ARIFUL HAQUE6, FAIKA HUSSAIN7
Abstract
Background: Acute pancreatitis is an acute inflammatory condition of the pancreas
that may extend to local and distant extrapancreatic tissues. The incidence of acute
pancreatitis in children has increased significantly in the past two decades. It can be
associated with severe morbidity and mortality. It should be considered in every child
with unexplained acute abdominal pain.
Objectives: To observe the clinical, biochemical and imaging profiles of acute
pancreatitis in children.
Methods: It was a cross-sectional study conducted at the Department of Pediatric
Gastroenterology & Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka
from January 2014 through June 2015. A total of 50 cases of acute pancreatitis were
included in this study. The diagnosis of acute pancreatitis was based on diagnostic
criteria of acute pancreatitis made by INSPPIRE group (If a child had any 2 of the 3
criteria: the abdominal pain compatible with acute pancreatitis, elevated serum amylase
and /or lipase level more than three times of upper limit of normal, imaging findings
compatible with acute pancreatitis). Clinical characteristics, laboratory and imaging
profile of the cases, complications were studied.
Results: Among 50 cases, male were 46% and male female ratio was 0.8:1. Mean
age at presentation was 10.2 ± 3.2 years. Forty eight (96%) patients had abdominal
pain which was severe agonizing in 81.3% cases. The common location of pain was
in epigastric region (77%). Pain radiating to back in 22.9% patients. Mean duration of
pain was 6.6 ± 4.4 days before hospital admission. Vomiting was present in 72%
patients followed by fever (30%). Two (4%) patients had jaundice. Ascites was noted
in 12% patients and abdominal mass in 6% patients. Out of 50 cases of AP, biliary
sludge was associated in 6% patients, biliary ascariasis in 4%, choledochal cyst in
2% and gallbladder stone in 2% patients. But in this study, 4% patients had Wilson
disease. Laboratory tests showed leukocytosis in 28% patients, high serum amylase
and lipase level in 56% and 58% patients respectively. Postive findings in ultrasonogram
were present in 66% patients. In the present study, hypocalcemia was found in 38%
patients, pseudocyst in 6% and pancreatic necrosis in 2% patients.
Conclusion: Although acute pancreatitis may present with varieties of clinical feature,
the most common one is abdominal pain and common location of pain is in epigastric
region. For confirmation of clinically diagnosed pancreatitis, both serum amylase and
lipase level and abdominal ultrasound are useful tools.
Keywrds: Clinical Profile, Acute pancreatitis.