2019, Number 1
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Acta Pediatr Mex 2019; 40 (1)
Acute pancreatitis in children. A perspective from the autopsy
Ridaura-Sanz C, Arias-Lima A
Language: Spanish
References: 17
Page: 11-15
PDF size: 349.38 Kb.
ABSTRACT
Objective: To describe the clinical and pathological features acute pancreatitis identified
at autopsy, as defined by the presence of aseptic necrosis of pancreatic parenchyma
with fat necrosis and saponification of adjacent tissues.
Materials and Methods: We identified and reviewed all cases with the pathology
diagnosis of acute pancreatitis in our autopsy records of 7250 studies performed from
1971 to 2011.
Results: Forty-four cases were identified, most of them in the last decade, suggesting
an increasing frequency of this condition. Only in a single case was pancreatitis the
primary disease, in a child dying after a scorpion bite. All other cases were associated
with an underlying condition, mostly cancer or systemic lupus erythematosus. The etiology
was drug related in most cases. A typical clinical picture was present in only 11
patients (25%). The clinical diagnosis of acute pancreatitis was established in 7 cases.
Conclusion: Acute pancreatitis in children is underdiagnosed. The definitions and
clinical criteria as referred in the literature overlook the characteristics of a population
with subclinical pancreatitis. Assay of pancreatic enzymes in all patients with risk
factors may lead to the timely identification of this condition.
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