Spectrum of acute, recurrent and chronic pancreatitis in children

2020 ◽  
pp. 1-11
Author(s):  
Muhammad Imran ◽  
Sabeen Abid Khan ◽  
Munir Iqbal Malik
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Retrospective Study ◽  
Medical Records ◽  
Clinical Presentation ◽  
Clinical Laboratory ◽  
Epigastric Pain ◽  
Paediatric Population ◽  
Older Children ◽  
Successful Recovery

Abstract Objective: To determine the clinical presentation, aetiology and outcome of pancreatitis in paediatric population. Method: The retrospective study was conducted at Shifa International Hospital, Islamabad, Pakistan, and comprised data of children with pancreatitis presenting between 2013 and 2018. Medical records were reviewed and findings of clinical, laboratory workup and management were noted on a specifically developed proforma. Data was analysed using SPSS 23. Results: Of the 51 subjects, 28(54.9%) were boys. The overall mean age was 10.6+4.9 years. The most frequent clinical symptom was epigastric pain 39(76.5%). The most common aetiology was gallstones/pancreatic stones 19(37.25%). Mean hospital stay was 5.1± 1.8 days, and it was longer in children aged up to 5 years compared to older children (p<0.05). Acute pancreatitis was seen in 23(45.09%) patients, followed by recurrent 19(37.25%) and chronic 9(17.64%). There was no mortality. Conclusion: Timely diagnosis and prompt management of hemodynamic status could lead to successful recovery without any serious complications in paediatric pancreatitis. Continuous...

scholarly journals The Management of Multi-Site, Bleeding, Visceral Artery Pseudoaneurysms, Secondary to Necrotising Pancreatitis

2009 ◽  
Vol 91 (3) ◽  
pp. 255-258 ◽  
Author(s):  
J Skipworth ◽  
D Raptis ◽  
D Brennand ◽  
C Imber ◽  
A Shankar
Keyword(s):  
Acute Pancreatitis ◽  
Epigastric Pain ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Fistula Formation ◽  
Visceral Artery ◽  
Haemodynamic Instability ◽  
Successful Recovery ◽  
Necrotising Pancreatitis ◽  
Tomographic Angiography

We present the case of a 45-year-old man, who presented to his local casualty department with severe epigastric pain following an alcohol binge, and was subsequently diagnosed with acute pancreatitis. Pancreatic necrosis with multiple collections ensued, necessitating transfer to an intensive care unit (ITU) in a tertiary hepatopancreaticobiliary centre. Initially, the patient appeared to slowly improve and was discharged to the ward, albeit following a prolonged ITU admission. However, during his subsequent recovery, he suffered multiple episodes of haematemesis and melaena associated with haemodynamic instability and requiring repeat admission to the ITU. Computerised tomographic angiography, followed by visceral angiography, was used to confirm the diagnosis of multisite visceral artery pseudoaneurysms, secondary to severe, necrotising pancreatitis. Pseudoaneurysms of the splenic, left colic and gastroduodenal arteries were sequentially, and successfully, radiologically embolised over a period of 9 days. Subsequent sequelae of radiological embolisation included a clinically insignificant splenic infarct, and a left colonic infarction associated with subsequent enterocutaneous fistula formation. The patient made a prolonged, but successful, recovery and was discharged from hospital after 260 days as an in-patient. This case illustrates the rare complication of three separate pseudoaneurysms, secondary to acute pancreatitis, successfully managed radiologically in the same patient. This case also highlights the necessity for multidisciplinary involvement in the management of pseudoaneurysms, an approach that is often most successfully achieved in a tertiary setting.

scholarly journals Positive predictive value of acute and chronic pancreatitis diagnoses in the Danish National Patient Registry: A validation study

2018 ◽  
Vol 48 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jakob Kirkegård ◽  
Marie R. Mortensen ◽  
Ida R. Johannsen ◽  
Frank V. Mortensen ◽  
Deirdre Cronin-Fenton
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Medical Records ◽  
Patient Registry ◽  
National Patient Registry ◽  
Danish National Patient Registry ◽  
National Patient ◽  
Acute And Chronic Pancreatitis

Aims: To examine the validity of the diagnoses of acute and chronic pancreatitis registered in the Danish National Patient Registry. Methods: We identified all patients in the Danish National Patient Registry admitted to two Danish hospitals with acute or chronic pancreatitis from 1996 to 2013. From this population, we randomly sampled 100 patients with acute pancreatitis and 100 patients with chronic pancreatitis. For each cohort, we computed the positive predictive values and associated 95% confidence intervals (CIs) for the discharge diagnosis of acute or chronic pancreatitis using medical records as the gold standard. Results: We identified 2617 patients with acute pancreatitis and 1284 patients with chronic pancreatitis discharged from either of the two hospitals during the study period. Of these, 776 (19.9%) had a diagnosis of both acute and chronic pancreatitis and are thus present in both cohorts. From the 200 sampled patients, a total of 138 (69.0%) medical records were available for review. The positive predictive value for a diagnosis of acute pancreatitis in the Danish National Patient Registry was 97.3% (95% CI 90.5–99.2%) and for chronic pancreatitis 83.1% (95% CI 72.2–90.3%). Conclusions: The validity of diagnoses of acute and chronic pancreatitis registered in the Danish National Patient Registry since 1996 is generally high.

scholarly journals Skin signs in acute pancreatitis: a case report

2013 ◽  
pp. 265-268
Author(s):  
Marco Bassi ◽  
Gelorma Belmonte ◽  
Paola Billi ◽  
Angelo Pasquale ◽  
Massimo Reta ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Clinical Laboratory ◽  
Epigastric Pain ◽  
Multiorgan Failure ◽  
Fluid Collection ◽  
Clinical Signs ◽  
Pancreatic Fluid Collection ◽  
Retroperitoneal Hemorrhage ◽  
Skin Signs

Introduction: Subcutaneous manifestations of severe acute pancreatitis (Cullen’s sign, Gray- Turner’s sign, Fox’s sign, and Bryant’s sign) are often discussed in journals and textbooks, but seldom observed. Although historically associated with acute pancreatitis, these clinical signs have been described in various other conditions associated with retroperitoneal hemorrhage. Case report: We describe the case of a 61-year-old male with no history of alcohol intake, who was admitted for epigastric pain, vomiting, and increasing serum amylase and lipase levels. Five days after admission, ecchymotic skin discoloration was noted over both flanks (Gray-Turner’s sign) and the upper third of the thighs (Fox’s sign). Ten days later, he developed multiorgan failure and was transferred to the ICU for 5 days. Computed tomography revealed a large pancreatic fluid collection, which was subjected to EUS-guided drainage. Cholecystectomy was later performed for persistent obstructive jaundice. After more than 4 months of hospitalization, he died as a result of severe gastrointestinal bleeding. Discussion and conclusions: Skin manifestations of retroperitoneal hemorrhage in a patient with acute pancreatitis indicate a stormy disease course and poor prognosis. The severity of acute pancreatitis is currently estimated with validated scoring systems based on clinical, laboratory, and imaging findings. However, skin signs like the ones discussed above can represent a simple and inexpensive parameter for evaluating the severity and prognosis of this disease.

scholarly journals Acute Pancreatitis and Acute Recurrent Pancreatitis: Investigation of Clinical and Etiological Factors

2021 ◽  
Author(s):  
Ferda Özbay Hoşnut ◽  
Gülseren Şahin ◽  
Ayla Akça Çağlar ◽  
Naz Güleray ◽  
Derya Erdoğan
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Congenital Anomalies ◽  
Clinical Laboratory ◽  
Common Factor ◽  
Hereditary Pancreatitis ◽  
Recurrent Pancreatitis ◽  
Common Causes ◽  
Idiopathic Acute Pancreatitis ◽  
Day By Day

INTRODUCTION: It was aimed to evaluate the etiology, clinical, laboratory and imaging findings and treatment methods of patients who have admitted with acute pancreatitis (AP) and progressed to chronic pancreatitis (CP) with ARP (acute recurrent pancreatitis). METHODS: The data of children under the age of 18 years who were admitted to our hospital between January 2013-July 2020 and were diagnosed with acute, acute recurrent or chronic pancreatitis according to INSPPIRE diagnostic criteria were evaluated retrospectively. RESULTS: There were 77 patients who were followed-up with the diagnosis of acute pancreatitis. Pancreatitis attack did not recur in 53/77 patients and no underlying cause was found in 35.84% (19/53) of the patients. The most common factor in those whose cause could be determined was gallstones (15.1%) (8/53). The pancreatitis attack recurred in 24 (31%) of the patients. Congenital anomalies (9/24) and hereditary pancreatitis (5/24) were the most common causes of pancreatitis in these patients and these factors were a risk factor for the recurrence of pancreatitis attack. There was no difference between the groups in terms of complications (p=0.423); however, chronicity was more common in the group with ARP (p=0.003). DISCUSSION AND CONCLUSION: Beside the pancreatitis is a rare disease in childhood, with the increase of awareness and increased accessibility to diagnostic imaging methods, more and more pancreatitis is diagnosed day by day. Idiopathic acute pancreatitis cases still constitute the largest group. If other causes are excluded in these cases, it is important to investigate congenital anomalies, genetic and metabolic etiologies

scholarly journals Factors Associated With the Presence of Tuberculous Empyema in Children With Pleural Tuberculosis

2021 ◽  
Vol 9 ◽  
Author(s):  
Yan-Hua Wu ◽  
Jun-Li Wang ◽  
Mao-Shui Wang
Keyword(s):  
Multivariate Analysis ◽  
Retrospective Study ◽  
Surgical Treatment ◽  
Low Temperature ◽  
Medical Records ◽  
Clinical Laboratory ◽  
Factors Associated ◽  
Pleural Tuberculosis ◽  
Logistic Regressions ◽  
Age And Sex

Background: Until now, the factor of tuberculous empyema (TE) in children with pleural tuberculosis (TB) remains unclear. Therefore, a retrospective study was conducted to assess the factors associated with the presence of TE in children.Methods: Between January 2006 and December 2019, consecutive children patients (≤ 15 years old) with suspected pleural TB were selected for further analysis. Empyema was defined as grossly purulent pleural fluid. The demographic, clinical, laboratory, and radiographic features were collected from the electrical medical records retrospectively. Univariate and multivariate logistic regressions were used to explore the factors associated with the presence of TE in children with pleural TB.Results: A total of 154 children with pleural TB (definite, 123 cases; possible, 31 cases) were included in our study and then were classified as TE (n = 27) and Non-TE (n = 127) groups. Multivariate analysis revealed that surgical treatment (age- and sex-adjusted OR = 92.0, 95% CI: 11.7, 721.3), cavity (age- and sex-adjusted OR = 39.2, 95% CI: 3.2, 476.3), pleural LDH (&gt;941 U/L, age- and sex-adjusted OR = 14.8, 95% CI: 2.4, 90.4), and temperature (&gt;37.2°C, age- and sex-adjusted OR = 0.08, 95% CI: 0.01, 0.53) were associated with the presence of TE in children with pleural TB.Conclusion: Early detection of the presence of TE in children remains a challenge and several characteristics, such as surgical treatment, lung cavitation, high pleural LDH level, and low temperature, were identified as factors of the presence of TE in children with pleural TB. These findings may improve the management of childhood TE.

scholarly journals A case report of portal vein thrombosis and common bile duct compression in the patient having pseudocyst of pancreas and its management by percutaneous trans-hepatic biliary drainage

2021 ◽  
Vol 8 (5) ◽  
pp. 1643
Author(s):  
Aafrin S. Baldiwala ◽  
Rajesh G. Chandnani
Keyword(s):  
Acute Pancreatitis ◽  
Chronic Pancreatitis ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Portal Vein ◽  
Venous Thrombosis ◽  
Clinical Presentation ◽  
Common Complication ◽  
Vein Thrombosis ◽  
Head Of Pancreas

Pancreatitis is a systemic disease owing to release of inflammatory mediators and digestive enzymes. Acute pancreatitis is sudden inflammation of the pancreas. Alcohol and gallstones are main cause of acute pancreatitis. Chronic pancreatitis is the persistent inflammation and irreversible fibrosis associated with atrophy of pancreatic parenchyma. There are various complications associated with pancreatitis such as strictures, pancreatic necrosis, pseudo-cyst of pancreas, pancreato-cutaneous fistulas, venous thrombosis, arterial aneurysm in various arteries around pancreas etc. Common bile duct (CBD) strictures are a common complication in patients with advanced chronic pancreatitis and have a variable clinical presentation ranging from an incidental finding to overt jaundice and cholangitis. CBD strictures occur as a consequence of recurrent acute inflammatory episodes which may ultimately result in a periductal fibrotic stricture. CBD can be compressed as a result of extrinsic compression by large pseudocyst or aneurysm. The diagnosis is mostly made during investigations for abdominal pain but jaundice may be the initial clinical presentation. The jaundice is typically transient but may be recurrent with a small risk of secondary biliary cirrhosis in longstanding cases. Vascular complications in chronic pancreatitis are rare. Venous thrombosis is the most common complication of pancreatitis affecting venous system. It occurs as consequences of an inflammatory mass in head of pancreas, and splenic vein thrombosis occurs in association with chronic pancreatitis in 4-8% cases. Present case is a case of acute pancreatic collection in head of pancreas with aneurysmal small bleeding causing complete CBD compression and extensive venous thrombosis involving superior mesenteric vein, portal vein, splenic.

scholarly journals CLINICAL AND LABORATORY ASPECTS OF ACUTE OBSTRUCTIVE BRONCHITIS IN CHILDREN INFECTED WITH MYCOPLASMA PNEUMONIAE

2020 ◽  
Vol 73 (6) ◽  
pp. 1229-1233
Author(s):  
Svitlana H. Usenko ◽  
Zalina V. Yeloeva ◽  
Maryna S. Diachenko ◽  
Serhiy A. Usenko
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Medical Records ◽  
Clinical Laboratory ◽  
Laboratory Data ◽  
Statistical Processing ◽  
Acute Bronchitis ◽  
Older Children ◽  
Systematic Analysis ◽  
History Of ◽  
Intracellular Infections

The aim of the work is to improve the prognosis of acute bronchitis on the basis of the study of etiology, clinical anamnestic and laboratory-instrumental features of acute bronchitis in children infected with Mycoplasma pneumoniae. Materials and methods: Medical records of inpatients, data from laboratory and clinical examinations, orders from the Ministry of Health of Ukraine. Statistical processing of the obtained results was carried out with the calculation of parametric and non-parametric criteria. The study included 72 patients with acute obstructive bronchitis, infected with Mycoplasma pneumoniae and patients not infected with intracellular pathogens who were hospitalized under the conditions of pediatric ward of children of younger and older children of the National Children’s Clinical Hospital №24. Results: Found that infected with mycoplasma compared with uninfected intracellular infection, more characteristic course of acute obstructive bronchitis on the background of febrile temperature with its duration of more than 4 days, the presence of midbubble and single dry or wet rales, as well as. In general, in patients infected with mycoplasma, compared with patients infected with chlamydia, there is a higher functional stress of immunity with the phenomena of exhaustion. Conclusions: Attention is drawn to the fact that clinical, laboratory data and immunological examinations with the use of systematic analysis make it possible to predict the consequences in the history of children with intracellular infections of various somatic pathologies. In doing so, multivariate and correlation analyzes make it possible to develop new diagnostic criteria.

scholarly journals Clinical, laboratory characteristics of a new Сoronavirus Infection in children in the Stavropol Territory

2021 ◽  
Vol 20 (4) ◽  
pp. 18-21
Author(s):  
S. M. Bezrodnova ◽  
N. A. Yatsenko ◽  
G. M. Sirazhov
Keyword(s):  
Retrospective Study ◽  
Infectious Diseases ◽  
Clinical Picture ◽  
Medical Records ◽  
Clinical Laboratory ◽  
Gastrointestinal Symptoms ◽  
Hospitalized Patients ◽  
Clinical Recovery ◽  
The World ◽  
Coronavirus Infection

A new coronavirus infection in children is more often asymptomatic or in mild forms, however, more and more severe cases of the disease have been recorded recently, and single deaths in children have been recorded in the world.The aim of the study was a clinical and laboratory analysis of the features of the course of a new coronavirus infection in children in the Stavropol Territory.Based on a retrospective study, 86 medical records of inpatient children who were treated at the Regional Specialized Clinical Infectious Diseases Hospital of the Stavropol Territory were analyzed with a diagnosis of U07.1 New coronavirus infection for the period from April 2020 to April 2021.The majority of hospitalized patients suffered from COVID-19 in a moderate form 59.3%. Children are more likely to become infected in family foci of infection – 51.2%. In 60% of cases, children are hospitalized 4—7 days from the onset of the disease. In the clinical picture, the leading symptoms were: fever (76.7%), cough (55.8%), weakness (38.4%), rhinitis (20.9%), gastrointestinal symptoms (12.8%). Pneumonia was detected in 37.2% of children. All patients were discharged with clinical recovery.

scholarly journals Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten year retrospective study

2019 ◽  
Vol 6 (10) ◽  
pp. 3794
Author(s):  
Ramu R. ◽  
Vergis Paul ◽  
Devipriya S. ◽  
Nevil C. Philip
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Presentation ◽  
Epigastric Pain ◽  
Tertiary Care ◽  
Fluid Collection ◽  
Clinical Profile ◽  
Alcoholic Pancreatitis ◽  
Systemic Complications ◽  
Idiopathic Pancreatitis ◽  
Common Clinical Presentation

Background: Acute pancreatitis is a complex condition with diverse local and systemic complications, dealt by the surgeons all over the world. There were no previous detailed studies regarding the etiology, clinical profile and outcome of acute pancreatitis in rural Kerala.Methods: This is a hospital based study by retrospective chart analysis of all acute pancreatitis cases from the past 10 years in this tertiary care centre which have clinical/ laboratory/ radiological findings suggestive of acute pancreatitis.Results: Among 436 cases studied 318 (72.9%) were males and 118 (27.1%) were females. Epigastric pain without radiation to the back (51.6%) was the most common clinical presentation. Alcohol was the most common etiological factor seen in 42.4% followed by idiopathic pancreatitis (IP) (36.9% cases) and then by gallstone/biliary pancreatitis (14.5%). Acute fluid collection was the most common local complication seen in 29.1% cases and respiratory system involvement was the most common organ involvement seen in 16.5% of cases.Conclusions: Epigastric pain without radiation to the back was the most common clinical presentation. Incidence of alcoholic pancreatitis (42.4%) and idiopathic pancreatitis (36.9%) was slightly higher in our study, which should prompt us to look with further studies for identifiable new aetiologies in the idiopathic group. This work provides the first known regional description of the etiology, clinical profile and outcome of acute pancreatitis. Due to institutional and population similarities, this may represent the status of developing countries in general. This will help in formulating a hospital policy which would be beneficial.

scholarly journals Primary Hyperparathyroidism and Pancreatitis: A Rare Association with Multiple Facets

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
I. Diallo ◽  
C. A. Fall ◽  
B. Ndiaye ◽  
M. Mbaye ◽  
I. Diedhiou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Chronic Pancreatitis ◽  
Parathyroid Hormone ◽  
Retrospective Study ◽  
Primary Hyperparathyroidism ◽  
High Rate ◽  
Parathyroid Surgery ◽  
Rare Association

Primary hyperparathyroidism (PHPT) is rarely associated with the occurrence of acute or chronic pancreatitis. Hypercalcemia plays a major role in the pathogenesis. We report five cases of pancreatitis revealing PHPT. Patients and Methods. This is a retrospective study of 4 years, including all patients admitted to intensive care unit or gastroenterology department, for an acute or chronic pancreatitis revealing primary hyperparathyroidism. Results. We included 5 patients, all female, with mean age 54 years [40–76 years]. The PHPT was in all cases revealed by acute pancreatitis (AP). This one was oedematous in four cases and severe in one case. It occurred twice in calcified chronic pancreatitis (CCP). There was hypercalcemia in all cases. The PHPT was associated with a high rate of parathyroid hormone in 4 cases. The secreting lesion was an adenoma in 5 cases. Two patients had in addition bilateral renal calcifications. The outcome was favorable in 4 patients among whom 3 have had parathyroid surgery. A death was noted by superinfection of necrosis in the case of severe AP. Conclusion. The occurrence of pancreatitis during hyperparathyroidism is rare. Normal or elevated calcemia during acute or chronic pancreatitis should always get attention.

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