소아 급성 췌장염의 임상적 고찰
Clinical Features of Acute Pancreatitis in Children
서정호, 김성헌, 정상건, 박재홍,
소속 상세정보
서정호 ( Seo Jung-Ho )
부산대학교 의과대학 소아과학교실
김성헌 ( Kim Seong-Heon )
부산대학교 의과대학 소아과학교실
정상건 ( Jeong Sang-Geon )
좋은강안병원 소아청소년과
박재홍 ( Park Jae-Hong )
부산대학교 의학전문대학원 소아과학교실
KMID : 0816120100130010058
Abstract
Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features.
Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007.
Results: Twenty males and 21 females (mean age, 8.7±4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3±553.2 and 766.2±723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure.
Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.
키워드
Acute pancreatitis; Children
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