ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ VIÊM TỤY CẤP TẠI BỆNH VIỆN NHI THÁI BÌNH

Abstract

Objectives: To describe clinical, paraclinical characteristics and results of treatment of acute
pancreatitis (AP) in children at Thai Binh Pediatric Hospital from 2018 to 2021.
Methods: This study was carried out from September 2018 to October 2021 at Thai Binh Provincial
Pediatric Hospital. All patients under 16 years diagnosed with AP according to the 2012 Atlanta
criteria were included in the study. Information on the general characteristics of the participants,
clinical and paraclinical characteristics and outcomes were collected by standardized questionnaires.
Results: 33 children with AP were included, including 8 children were diagnosed in 2018-2019, 9
children in 2020 and 16 children in 2021. Most of patients were male of school age (≥6 years old).
All children presented with abdominal pain. Most children had intermittent abdominal pain, mild
to moderate. 60.6% of children presented vomiting and 24.2% had fever. 21.2% of patients were
diagnosed with AP due to common bile duct cysts, gallstones, 6.1% of children had acute pancreatitis
due to genetic metabolic diseases. AP of unknown etiology occurred in 60.6% of the total patients.
Changes in complete blood count were mainly leukocytosis and polymorphonuclear leukocytes with
the rate of 60.6% and 78.8%, respectively. Blood lipase levels increased 3 times normal in 92.9% of
pediatric patients, while blood amylase increased 3 times normal only in 75.8% of patients. 36.4%
of children had increased CRP. 63.6% had hyperglycemia. 27 children (81.8%) were treated by
medical methods. Surgical treatment accounted for 18.2%, mainly treating the cause of AP. 66.7%
were discharged, 30.3% of patients developed recurrent acute pancreatitis after treatment, the rate of
complicated acute pancreatitis was 3%, no children died. Length of stay was 11.3±5.9 days.
Conclusion: The incidence of AP among children tends to increase over the years. Abdominal pain
and vomiting are the two most common symptoms. CT Scanner is a good diagnostic method for
AP. Most of the patients in the study responded to medical therapy alone. Indications for surgical
treatment are mainly to treat the cause of AP.