WOFAPS 2025 8th World Congress of Pediatric Surgery

Fatma Thamri, Senda Houidi, Bochra Aziza, Yasmine Houas, Yosra Kerkeni, Sondes Sahli, Riadh Jouini, Said Jlidi

Department of Pediatric Surgery, Children’s Hospital, Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

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Purpose

Pediatric pancreatitis remains an area with significant gaps in understanding. Its etiologies and outcomes differ from those in adults. Once considered rare, its incidence is rising and can lead to considerable morbidity and mortality, particularly in severe cases.

We aim to investigate the clinical characteristics and etiological factors of AP in children

Methods

We conducted a retrospective review of 27 pediatric patients diagnosed with acute pancreatitis over the past 15 years. This study analyzed patient demographics, clinical symptoms, diagnostic results, and outcomes using data extracted from medical records for a thorough evaluation

Results

The median age of the patients was 9 years [8.43-14.7]. Predominant symptoms were abdominal pain in 95% of cases and vomiting in 33%. Serum amylase levels were high in all patients. Abdominal ultrasound, performed at a median of 1 day, identified peripancreatic edema in 63% of cases, while the pancreatic duct was visible in 35% and dilated in 12%. Contrast-enhanced CT scans, conducted at a median of 52 hours, showed abnormalities in 54% of cases. The identified etiologies included biliary causes in 9 patients, idiopathic origins in 3, hypertriglyceridemia in 2, medication-induced pancreatitis in 1, trauma in 5 and anatomical anomalies in 6. Mild pancreatitis was noted in 88.9% of patients and managed with analgesics, bowel rest, and intravenous fluids. Severe cases, affecting 11.1% of patients, included 2 fatalities and 2 instances of pancreatic pseudocysts, one of which required surgical drainage. Eight patients (29.6%) experienced recurrent AP.

Conclusion

Acute pancreatitis should be considered in pediatric patients presenting with abdominal pain. The condition has a broad spectrum of etiological factors, and a significant proportion of cases are idiopathic. The prognosis varies, reflecting the heterogeneous nature of the disease in children.