Clinical Characteristics of Acute and Chronic Pancreatitis in Children and Impact of Obesity.

Objectives: In the contest of increasing rates of obesity in children, through this study, we aimed to evaluate the impact of obesity on Asian pediatric acute pancreatitis (AP) and chronic pancreatitis (CP).

Methods: The medical records of patients aged<18 years with AP and CP across 11 Korean centers were reviewed retrospectively. To stratify the severity of acute pancreatitis, Ranson score, modified Glasgow score and revised Atlanta severity classification were used. Patients were categorized by body mass index percentile for the analysis. We also evaluated blood parameters to predict severe AP.

Results: We enrolled 301 patients (obesity: n= 61; overweight: n=40; normal-weight: n=200) with AP and 19 patients (obesity: n=5; overweight: n=4; normal-weight: n=10) with CP. The rate of moderately severe/severe AP was significantly higher in the obesity group than that in the overweight and normal-weight groups (41.0% vs. 17.5% vs. 4.5%). The obesity group demonstrated a significantly higher incidence of organ failure (16.4% vs. 1.5%) and pancreatic necrosis (41.0% vs. 4.0%) that the normal-weight group. According to multivariate analysis, obesity and overweight were predictors of moderately severe/severe AP. Among the various blood parameters, glucose was found to be most highly correlated with AP severity in receiver operating characteristic analysis. In CP, the mean number of hospital admission was 5.2 times and the times computed tomography was performed was 3. Genetic and imaging abnormalities occurred in 12 (63.2%) and 12 (63.2%) patients, respectively. Exocrine and endocrine pancreatic insufficiencies occurred in two (10.5%) and five (26.3%) patients, respectively.

Conclusions: Obesity significantly impacted both length of hospital stay and AP severity in Asian children.