Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis

Abstract

Background: Acute pancreatitis is a painful inflammatory disorder known to occur in children. Recent reports, primarily on the basis of adult data, have suggested an increasing incidence. However, pediatric studies are limited.

Objective: The study was performed to examine the frequency of acute pancreatitis in a pediatric population from 1994 to 2007 and to characterize etiologies by age subsets.

Patients and methods: In this retrospective study, cases of pancreatitis were identified by ICD-9 codes and subjected to inclusion criteria.

Results: Two hundred and seventy-one cases of pancreatitis met inclusion criteria. Mean age of the subjects was 13.1 +/- 5.6 years. The recurrence rate was 15.3%. Biliary disease was the most common etiology (32.6%). Acute pancreatitis cases evaluated at a single tertiary care center increased 53% between 1995 to 2000 and 2001 to 2006 (P < 0.02). However, when cases were normalized by all annual pediatric emergency department visits for all medical reasons, the increase was reduced to 22% and lost statistical significance (P = 0.16). The rise was not associated with a change in etiologies or body mass index (BMI).

Conclusions: This is the first report demonstrating that an increase in pediatric pancreatitis may in part be due to growing referrals to tertiary care centers. The data on etiologies, particularly with regard to differing ages, may be helpful in managing children who present with acute pancreatitis.

FIG. 1

Study flow. The chart begins with total number of patient records initially screened. Patients that met inclusion criteria were further divided on the basis of having had single episodes versus recurrent pancreatitis. *Methods for details of each inclusion criteria.