Background: Acute pancreatitis (AP) in children ranges in severity from mild disease, to a moderate and severe inflammation with local and systemic complications mandating prolonged hospitalization and invasive procedures. Data regarding predicting factors of severity in children is limited. This study aimed to investigate laboratory markers at presentation as predictors of disease severity.
Methods: A retrospective study of all children (<18y) hospitalized with AP between January 1995 to December 2015 was conducted. Patient demographics, clinical, laboratory and imaging data were reviewed. The primary outcomes were disease severity, hospitalization duration and endoscopic and surgical interventions.
Results: 68 children with a total number of 117 hospitalizations for AP were identified, including 59 (59.3% males, median age 135 months, interquartile range 70-186) children with first episode hospitalizations. Of the latter, 51 patients (86.4%) had mild and 8 had moderate or severe disease. Median duration of hospitalization was 6 days (range- 4-8). 55 (93.2%) children were treated conservatively, 3 (5%) underwent therapeutic endoscopic intervention and 1 (1.69%) underwent surgery. 14 (23.73%) children had AP recurrence. There was no mortality. Patients with moderate/severe AP had higher WBC, amylase and lipase levels at presentation compared to patients with mild AP (23.8 vs. 11.1, p=0.032; 1376 vs. 313, p=0.05; and 1200 vs. 363, p=0.041, respectively). WBC > 14.2, amylase > 1200 and lipase > 1200 (OR 2.9, 7.4, 5.3, respectively) predict a moderate/severe disease.
Conclusion: AP in children is generally a mild disease amenable to conservative management. Surrogate markers of pancreatic inflammation- WBC, amylase and lipase at presentation are predictors of disease severity.
