Acute pancreatitis in childhood – a comparative international study and tale of two cities
Issued Date
2023-01-01
Resource Type
ISSN
14451433
eISSN
14452197
Scopus ID
2-s2.0-85180197811
Journal Title
ANZ Journal of Surgery
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SCOPUS
Bibliographic Citation
ANZ Journal of Surgery (2023)
Suggested Citation
Salim A., Boonthai A., Tanpowpong P., Losty P.D. Acute pancreatitis in childhood – a comparative international study and tale of two cities. ANZ Journal of Surgery (2023). doi:10.1111/ans.18840 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/95631
Title
Acute pancreatitis in childhood – a comparative international study and tale of two cities
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Abstract
Backgrounds: To compare factor(s) contributing to aetiology, management and clinical outcome(s) of paediatric patients acquiring acute pancreatitis (AP) at two major university paediatric surgical centres in Liverpool and Bangkok. Methods: All patients (<18 years) with an index diagnosis of AP (ICD 10 coding) during 2006–2016 were studied. Results: 121 patients included n = 79 (65.3%) in Thailand versus n = 42 (34.7%) in the UK centre with no difference(s) in age at diagnosis at 10.4 ± 4.5 and 11.7 ± 6 years. (P = 0.12). Major AP aetiology(s) in Thailand were medications (39.2%) and choledochal cysts (8.9%). In the UK—gallstone disease (21.4%), and medications (16.7%) were leading factors (P < 0.01). Ultrasonography was deployed more frequently in the UK versus Thai centre (74.3% vs. 49.1%; P < 0.01). Pancreatitis was confirmed by imaging in 67.9% (Thai) and 62.9% (UK) patients (P = 0.47). Most patients at both centres had a mild-grade pancreatitis illness (95% Thai vs. 90.5% UK; P = 0.28) while 12.7% of Thai and 19% of UK children developed pancreatitis-related complication (P = 0.37). Overall mortality rate (%) was significantly higher in the Thai versus UK centre (27.8% vs. 9.5%; P = 0.02). Conclusions: Aetiology of acute pancreatitis appears to vary between UK and Thailand children. Timely early diagnosis and healthcare pathways may be driven by local patient-related factor(s). The higher mortality (%) observed in Thailand versus UK in this comparative study was linked to underlying co-existent chronic medical condition(s) in vulnerable patient cohorts.