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ACUTE PANCREATITIS IN CHILDREN: RARE?

INTRODUCTION: Acute pancreatitis is a necroinflammatory tissue reaction to the functional and/or structural damage of acinar cells and rarely necrosis of ductal cells, caused by non-infectious factors. In acute pancreatitis, there is extensive release of pancreatic enzymes along with their intrapancreatic activation, which can cause peripancreatic necrosis. In children, this disease is little studied. Therefore, the objective of this study is to understand the profile of acute pancreatitis in children. METHOD: A horizontal systematic review of acute pancreatitis in children was carried out using the PRISMA method in the Pubmed database. Descriptors: "acute pancreatitis AND [children OR child OR childhood]". Also added articles related to the topic/sessions "cited by" and "similar articles". RESULTS: Of the initial 43, 12 articles were selected, with the United States being the country with the largest number of published works. The white ethnic group had a higher incidence of cases and the ratio among women varied between 32.4% and 59.5%; and men, between 40.5% and 67.5%, and it is not possible to say that there is gender prevalence. The average age of patients ranged from 5 to 11.6 years. The main etiologies identified by the studies were: biliary tract diseases, idiopathic causes, medication and systemic disease. DISCUSSION: Surprisingly, we found few articles, making it difficult to analyze the topic, as case reports and retrospective studies on acute pancreatitis in children were found without standardization regarding age range and etiology, with large variations regarding which etiologies were being taken into consideration and the ages minimum and maximum. Therefore, considering the available information, it can be concluded that biliary tract diseases constitute the main etiology of acute pancreatitis in children, which coincides with literature on the etiology of acute pancreatitis in adults. CONCLUSION: The lack of consensus on diagnostic parameters and the neglect of gastric symptoms in children may have led to an underdiagnosis of cases of acute pancreatitis. Furthermore, underreporting of these cases has led to little available literature on acute pancreatitis in children and perhaps a false idea of a rare disease. Therefore, it is important to have a new look at gastrointestinal symptoms in children and a better diagnostic standard for this disease.

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ACUTE PANCREATITIS IN CHILDREN: RARE?

  • DOI: 10.22533/at.ed.1593962321117

  • Palavras-chave: Acute pancreatitis, Children, Etiology, Review

  • Keywords: Acute pancreatitis, Children, Etiology, Review

  • Abstract:

    INTRODUCTION: Acute pancreatitis is a necroinflammatory tissue reaction to the functional and/or structural damage of acinar cells and rarely necrosis of ductal cells, caused by non-infectious factors. In acute pancreatitis, there is extensive release of pancreatic enzymes along with their intrapancreatic activation, which can cause peripancreatic necrosis. In children, this disease is little studied. Therefore, the objective of this study is to understand the profile of acute pancreatitis in children. METHOD: A horizontal systematic review of acute pancreatitis in children was carried out using the PRISMA method in the Pubmed database. Descriptors: "acute pancreatitis AND [children OR child OR childhood]". Also added articles related to the topic/sessions "cited by" and "similar articles". RESULTS: Of the initial 43, 12 articles were selected, with the United States being the country with the largest number of published works. The white ethnic group had a higher incidence of cases and the ratio among women varied between 32.4% and 59.5%; and men, between 40.5% and 67.5%, and it is not possible to say that there is gender prevalence. The average age of patients ranged from 5 to 11.6 years. The main etiologies identified by the studies were: biliary tract diseases, idiopathic causes, medication and systemic disease. DISCUSSION: Surprisingly, we found few articles, making it difficult to analyze the topic, as case reports and retrospective studies on acute pancreatitis in children were found without standardization regarding age range and etiology, with large variations regarding which etiologies were being taken into consideration and the ages minimum and maximum. Therefore, considering the available information, it can be concluded that biliary tract diseases constitute the main etiology of acute pancreatitis in children, which coincides with literature on the etiology of acute pancreatitis in adults. CONCLUSION: The lack of consensus on diagnostic parameters and the neglect of gastric symptoms in children may have led to an underdiagnosis of cases of acute pancreatitis. Furthermore, underreporting of these cases has led to little available literature on acute pancreatitis in children and perhaps a false idea of a rare disease. Therefore, it is important to have a new look at gastrointestinal symptoms in children and a better diagnostic standard for this disease.

  • Karina de Oliveira Pinheiro
  • Pamela dos Santos Monteiro
  • Julye Tainah de Fátima Seminari Pagani
  • Beatriz Tezzon
  • Roberta Rezende Lara
  • Ethel Zimberg Chehter
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