Original articleEtiology and Outcome of Acute Pancreatitis in Infants and Toddlers
Section snippets
Methods
We reviewed medical records of all children under age 3 years admitted to Children’s Hospital of Pittsburgh with a diagnosis of AP (ICD-9 577.0) between January 1995 and December 2004. Criteria for diagnosis of AP included acute symptoms indicating a change from the usual health of the patient and a 3-fold or greater elevation in serum amylase (normal, <90 IU/L) or lipase (normal, <200 IU/L), abnormal radiologic or surgical findings consistent with AP, or both biochemical and radiologic
Results
We identified 947 cases of AP in children of all ages. Of these children, 109 (11.5%) were under age 3 years; 87 of the 109 met our inclusion criteria. Two children with appendicitis were excluded. AP was the admitting diagnosis in only 21 of the 87 children (24%). Most of the children (66; 76%) were admitted for other illnesses and were diagnosed with pancreatitis while hospitalized.
The study group comprised 45 (51.7%) males and 42 (48.2%) females, with a median age at presentation of 20
Discussion
Our study is complicated because there is no easily applied standard for the diagnosis of AP. Our definition of AP is similar to that used in previous studies and represents reasonable, stringent criteria.2, 4, 5 Requiring clinical, biochemical, and radiologic evidence of AP underestimates disease incidence, because patients can have AP with only biochemical changes.9, 10, 11 Including patients with clinical and biochemical evidence of AP without radiologic changes may overestimate the
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