BACKGROUND The diagnosis of pediatric pancreatitis has been increasing over the last 15 years but the etiology of this is uncertain. The population of pre-adolescent patients with pancreatitis in the emergency department has not been specifically described. Our objective was to determine the characteristics of these patients to illuminate this population and disease in order to better identify them and avoid a delay in diagnosis and treatment. METHODS This was a retrospective descriptive study of consecutive pediatric patients under the age of 13 years between 2006 and 2016 who presented to our pediatric emergency department with a diagnosis of atraumatic pancreatitis. Patient characteristics, lab and imaging results, identified etiology of pancreatitis, and recurrence rates were recorded and evaluated. RESULTS There were 139 visits, of which 85 were for a first episode of acute pancreatitis, and 54 were patients with an episode of recurrent pancreatitis. The median age for all visits was 8 years (IQ range 5-11). Of the acute cases, 26% had uncertain or undetermined etiologies of which half were thought to likely be viral related; 20% had systemic inflammatory or autoimmune diseases; 19% were associated with medications, with the most common being valproic acid; 16% were cholelithiasis-related; and 15% were found to have a genetic, congenital or structural etiology. No patients had elevated triglycerides. Those with cholelithiasis and genetic or structural defects were found to have a higher recurrence rate than those with other etiologies. There were only four patients diagnosed with chronic pancreatitis. CONCLUSIONS The etiology of pancreatitis in pre-adolescent children has a different distribution than in adolescents and adults, with gallstone disease less frequent and concurrent contributing illness more common. Patients on pancreatitis-causing medications or with known genetic risk or structural pancreatic problems should be tested for pancreatitis if presenting with concerning symptoms. Hypertriglyceridemia and chronic pancreatitis with evidence of pancreatic exocrine insufficiency is uncommon in this population.

中文翻译：

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青春期前儿童的胰腺炎：在小儿急诊科有10年的工作经验。

背景技术在过去的15年中，小儿胰腺炎的诊断一直在增加，但是其病因尚不确定。急诊科的青春期前胰腺炎患者人群尚未具体描述。我们的目标是确定这些患者的特征，以阐明该人群和疾病，以便更好地识别它们并避免诊断和治疗的延迟。方法这是一项回顾性描述性研究，研究对象是2006年至2016年间连续13岁以下的小儿患者，他们向我们的小儿急诊科诊断为无创伤性胰腺炎。记录并评估患者的特征，实验室和影像学结果，确定的胰腺炎病因以及复发率。结果共有139次访问，其中85例是急性胰腺炎的首发，54例是复发性胰腺炎的患者。所有就诊的平均年龄为8岁（智商范围5-11）。在急性病例中，有26％的病因不确定或不确定，其中一半被认为与病毒有关。20％患有全身性炎症或自身免疫性疾病；19％与药物有关，最常见的是丙戊酸；16％与胆石症有关；发现有15％的人有遗传，先天或结构性病因。没有患者甘油三酯升高。发现胆石症和遗传或结构缺陷者比其他病因者有更高的复发率。只有四名患者被诊断出患有慢性胰腺炎。结论青春期前儿童中胰腺炎的病因分布与青少年和成人不同，胆结石疾病的发病率较低，同时并发疾病的发病率更高。如果患者出现引起胰腺炎的药物或具有已知遗传风险或结构性胰腺问题，则应检查其是否患有胰腺炎，如果出现相关症状。高甘油三酸酯血症和慢性胰腺炎伴有胰腺外分泌功能不全，在该人群中并不常见。