Pancreatitis in Pre-Adolescent Children

Abstract Background Pediatric pancreatitis is increasing, whether due to an increase in cholelithiasis or factors such as increased awareness and testing. This study was to describe previously undescribed pre-adolescent children with pancreatitis to illuminate this population and clarify who should be screened for pancreatitis. Methods This is a descriptive retrospective study of emergency department patients <13 years old over 10 years with the diagnosis of pancreatitis. Demographics, laboratory values, imaging results and final diagnoses/etiologies were recorded and evaluated using descriptive statistics. Results 100 patients presented with acute pancreatitis and median age of 8 years (IQ range 5-11). 25% were attributed to an unknown etiology. 16 were medication induced, 13 genetic/congenital/structural, 14 traumatic/post surgical, 14 had gallstones, and 17 had autoimmune or systemic illness-related pancreatitis. 29 patients had recurrent pancreatitis. Conclusions Cholelithiasis is a much less frequent etiology in children than in adults. Genetic/structural factors represent a larger proportion of acute cases and higher proportion of recurrent pancreatitis. Concurrent systemic and viral illnesses are more common than in adults. Patients on pancreatitis-causing medications or with known genetic/structural issues should be tested for pancreatitis. Patients without risk factors rarely developed recurrent pancreatitis. Hypertriglyceridemia was not found to be an etiology. Chronic pancreatitis was uncommon.