Clinical spectrum and outcome of pancreatic disorders in children.

Abstract

Objective: To determine the clinical spectrum and immediate outcome of pancreatic disorders in children attending National Institute of Child Health, Karachi, Pakistan. Study Design: Cross Sectional study. Setting: Inpatient and Outpatient Department of Pediatric Medicine, National Institute of Child Health, Karachi. Period: January 2022 to December 2022. Material & Methods: A total of 49 children of either gender aged between 2 to 15 years presenting with clinical features of pancreatic disorders were analyzed. At the time of enrollment, data about demographic and clinical characteristics were noted. Important laboratory investigations were sent to local institutional laboratory. Ultrasound and/or CT scan of abdomen of each child was performed and reported by consultant radiologist having 3 years of experience for confirmation of the diagnosis. Immediate outcome was noted after 15 days of treatment among all children. Outcomes were labeled in terms of improved, not improved or expired. Results: In a total of 49 children, 30 (61.2%) were male while the mean age was 8.46±3.40 years. Epigastric pain, vomiting and whole abdominal pain were the most frequent presenting complaints noted in 40 (81.6%), 35 (71.4%) and 32 (65.3%) children respectively. Atrophy, inflammation and edema, calcifications, pancreatic duct dilation and pancreatic divisum were the commonest radiological findings noted in 10 (20.4%), 21 (42.9%), 18 (36.7%), 13 (26.5%) and 2 (4.1%) children respectively. Chronic pancreatitis was found to be the most frequent pancreatic disorder in 29 (59.2%) patients and they were associated with low fecal elastase level while acute pancreatitis was noted in 20 (40.8%) cases. Improved outcomes were observed in 44 (89.8%) children while no mortality was reported. Conclusion: Majority of the children with pancreatic disorders were male and aged between 6 to 12 years. Chronic pancreatitis was the most common type of pancreatic disorder. Epigastric pain, vomiting and whole abdominal pain were the most frequent presenting complaints. Outcome was generally good and no mortality was noted.