SUPPORTIVE care is the main approach when it comes to treating acute pancreatitis. Retrospective studies of the causes and characteristics of hospitalised patients can help pinpoint and eliminate potential triggers, according to a study led by Martin Lass, Department of Paediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany. Data were presented at the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) 56th Annual Meeting.
This study conducted a retrospective analysis of all hospitalised cases of acute, acute-recurrent, and chronic pancreatitis at the University’s Children’s Hospital from 2000–2022. The team searched the hospitals’ documentation system for all children hospitalised with the international classification of diseases numbers K85 and K86.1. Acute, acute-recurrent, and chronic pancreatitis, though distinct, can overlap, as those with chronic pancreatitis may experience acute episodes. This study recorded and analysed patients’ age, sex, aetiology of pancreatitis, chronicity, and other information.
The study examined 210 children and adolescents (115 female and 95 male) aged 0–17 years, with an average age of 11.5 years. In 72 children and adolescents (32%) with pancreatitis, no cause was found, and hence they were categorised as idiopathic. The most common causes of acute pancreatitis were medications (n=39), genetic causes (n=25), and gallstones (n=18). Genetic causes were the most common in patients with acute recurrent episodes and chronic pancreatitis (n=40). The most frequently mutated genes were CTFR (n=8), SPINK1 (n=10), and PRSS1 (n=4). Among those with drug-associated pancreatitis, 18 had inflammatory bowel disease (IBD) and could not tolerate azathioprine or mesalazine. Additionally, 12 patients with cancer developed pancreatitis from using asparaginase.
Of the 32 patients diagnosed with IBD, 18 cases were due to medication, and 14 had extraintestinal manifestations, with 12 of those having ulcerative colitis. Autoimmune pancreatitis was found only in a 14-month-old male.
The study identified a wide range of causes for pancreatitis in children and adolescents, which physicians need to consider when diagnosing the condition. Metabolic causes were more prevalent in preschool-aged children, whereas alcohol was the most common cause in adolescents. In patients with IBD, distinguishing whether pancreatitis is a result of the disease, its treatment, or both, can be challenging.
