ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH VIÊM TỤY CẤP Ở TRẺ EM TẠI BỆNH VIỆN NHI THANH HÓA

Abstract

Acute pancreatitis is a condition characterized by pancreatic cell injury caused by autodigestion from pancreatic enzymes, ranging in severity from mild to severe, with necrotizing pancreatitis that may be fatal if not treated promptly. Aims: To describe the clinical and paraclinical characteristics of pediatric acute pancreatitis at Thanh Hoa Pediatric Hospital. Materials and Methods: A prospective descriptive study was conducted on 51 children diagnosed with acute pancreatitis based on the revised Atlanta 2012 criteria. All patients received treatment at the Department of Gastroenterology, Thanh Hoa Children’s Hospital. Results: The mean age at diagnosis was 7.7 ± 3.9 years. The male-to-female ratio was 1.3:1. Severe acute pancreatitis accounted for 25.5% of cases. The prevalences of children presenting with abdominal pain and nausea and/or vomiting were 98% and 66.7%, respectively, with no significant differences in these symptoms between the mild and severe acute pancreatitis groups. Early onset of fever was suggestive of severe acute pancreatitis. Laboratory investigations revealed elevated serum lipase and amylase levels in 76.7% and 52.9%, respectively. Leukocytosis and neutrophilia were observed in 66.7% and 56.9% of patients, while increased C-reactive protein (CRP) was found in 41.2%. Imaging findings showed pancreatic abnormalities in 62.7% on abdominal ultrasound and in 82.1% on computed tomography (CT). Conclusion: The diagnosis of acute pancreatitis in children remains clinically challenging due to its nonspecific presentation. However, serum enzyme assays (amylase and lipase) and imaging modalities such as ultrasound and CT play a crucial role in early detection and management.