Clinical Characteristics and Early Prognosis of Acute Pancreatitis in Children with Different Etiologies

Abstract

Background: Acute pancreatitis (AP) is an acute abdominal condition characterized by the abnormal activation of pancreatic enzymes, leading to digestive damage to the pancreas and neighboring organs, with local pancreatic inflammation as a prominent feature. Objectives: The present study aimed to investigate the clinical characteristics and early prognosis of AP in children with different etiologies. Methods: A total of 102 pediatric patients aged 4 - 15 years diagnosed with AP and admitted to Baoding Hospital, Beijing Children’s Hospital affiliated with Capital Medical University from January 2023 to December 2024 were included. Their etiologies, clinical symptoms, laboratory parameters, treatment approaches, and prognoses were analyzed retrospectively. Results: Among the 102 AP cases, the etiologies were biliary (23.5%, 24/102), anatomical abnormality-related (15.7%, 16/102), idiopathic (28.4%, 29/102), drug-induced (6.9%, 7/102), and traumatic (25.5%, 26/102). The proportions of mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP) were 61.8% (63/102), 21% (28/102), and 11% (11/102), respectively. Clinical symptoms mainly included abdominal pain (87.3%, 89/102), vomiting (59.8%, 61/102), fever (36.3%, 37/102), abdominal distension (13.7%, 14/102), and diarrhea (6.9%, 7/102), with other symptoms accounting for 12.7% (13/102). The completion rate of ultrasonography was 88.2% (90/102), with a positive rate of 74.4% (67/90). Abdominal computed tomography had a completion rate of 98.0% (100/102) and a positive rate of 85% (85/100). Magnetic resonance cholangiopancreatography (MRCP) had a completion rate of 55.9% (57/102) and a positive rate of 91.2% (52/57). Significant differences in white blood cell count (WBC), C-reactive protein (CRP), blood glucose (GLU), and blood calcium (Ca) were observed among children with AP of different etiologies (P < 0.05, respectively). Among patients with MSAP, the primary complication was pancreatic pseudocyst (32.1%, 9/28), while patients with SAP predominantly experienced respiratory dysfunction (54.5%, 6/11). The proportion of patients receiving intravenous fluid therapy was 98.0% (100/102), and 70.6% (72/102) received nasogastric or enteral feeding therapy, initiated at day 5.49 ± 1.80 and lasting for 10.46 ± 5.26 days. Favorable treatment outcomes were observed in 101 cases (99.0%). Conclusions: This study provided useful information about the characteristics and outcomes of pancreatitis in children, showing that the most common clinical symptom was abdominal pain, the most common cause was idiopathic, most cases were mild, and the outcomes were satisfactory.