Abdominal trauma before the onset of chronic pancreatitis – cause of disease or fortuity?
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 5
Abstract
Introduction. The most common causes of chronic pancreatitis (CP) in children differ significantly from those reported in adults. The most important are gene mutations, anatomic anomalies of pancreatic ducts, lipid disorders and biliary tract diseases. A large percent of CP cases (30-40%) is still described as idiopathic. It is known that one of the most common causes of acute pancreatitis in children is abdominal trauma. Major injuries cause damage of pancreatic duct, pancreatic juice outflow disorder, and the formation of pseudocysts. Small injuries can initially cause no clinical symptoms, and appear after months or years as CP.Current knowledge about the potential role of abdominal trauma in the etiology of chronic pancreatitis is limited to the descriptions of case reports or small groups of patients, mainly adults.Aim. The aim of our study was to evaluate the role of abdominal trauma as a cause of chronic pancreatitis in children.Material and methods. 238 children with chronic pancreatitis were enrolled into the study. Data was analyzed in terms of the causes of chronic pancreatitis taking into account: medical history, including coexistence of biliary or lipid disorders, family history, results of imaging studies, the presence of mutations in genes associated with CP (CFTR, SPINK1, PRSS1).Results. In 10 children (4.2%) was found a clear relationship between abdominal trauma and the first exacerbation of chronic pancreatitis. In 3 cases it was a „classic” bicycle injury. Four children were beaten (kick or blow with a fist in the stomach). One child has been heavily hit by the ball in the stomach, one – fell from the tree. In 6 of the 10 patients (60%), abdominal trauma coexisted with other etiological factors of CP.Conclusions. Abdominal trauma is probably not the cause of CP by itself, but only a factor revealing/initiating inflammation in patients who are predisposed to it.
Authors and Affiliations
Elwira Kołodziejczyk, Karolina Wejnarska, Jarosław Kierkuś, Józef Ryżko, Grzegorz Oracz
Keywords
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