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Étude rétrospective sur les facteurs de risque, la prise en charge et le taux de complications des pancréatites chez les enfants
Authors: --- ---
Year: 2016 Publisher: Bruxelles: UCL. Faculté de médecine,

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Abstract

Pancreatitis is a rare disease in pediatrics. Studies have shown that it affects about 4 to 13 children out of 100.000. In addition, 10-35% of these patients will develop chronic pancreatitis. As for the children, the var10us causes of pancreatitis are traumatic, toxic, genetic, auto­ immune, infections or obstructive. Sometimes, no cause can be found ("idiopathic").Until recently; "idiopathic" pancreatitis was the leading cause of pancreatitis for children. However, the recent development of genetic screening techniques and imaging techniques indicate that many pancreatitis, previously called idiopathic, were actually genetic or malformative. The main objective of the study is to identify cases of pancreatitis and to determine the frequency of occurrence of the various causes of pancreatitis in the 59 children treated at Saint-Luc University Hospital between January 2014 and August 2016.To carry out this thesis, a comparative table with several data of the patients has been produced. Among other data, demographic information such as age, sex, ethnic origin, age of the first episode, consanguinity, presence of passive smoking have been included. Regarding the etiology of pancreatitis, it has been investigated on the basis of the TIGAR-o classification. The various complications and complementary examinations such as ultrasound, CT scan, MRI, endoscopic ultrasound and / or CWR have been listed according to each patient. The results highlighted that several etiologies were often found for the same patient. For 18.6% of children, more than 2 joint causes were responsible for pancreatitis. In the study, the etiologies found are, in order of frequency, obstruction, autoimmune origin, metabolic origin and abdominal trauma, idiopathic origin, genetic mutation and toxic/drug. Unlike adults, environmental factors do not influence the occurrence of pancreatitis concerning children. In the vast majority of cases (76.3%), no complications occurred for the children in a treatment program for about 4 years at Saint-Luc University Hospital. The most frequent complication is the pseudocyst for 17% of patients. La pancréatite est une maladie rare en pédiatrie. Les études démontrent qu'elle touche environ4 à 13 enfants sur 100.00033. En outre, 10 à 35% de ces patients évolueront vers une pancréatite chronique. Chez les enfants, les différentes causes de pancréatites sont traumatiques, toxiques, génétiques, auto-immunes, infectieuses ou obstructives. Parfois aucune cause n'est retrouvée (« idiopathique »). Jusqu'il y a peu, la pancréatite « idiopathique » était la cause principale de pancréatite chez l'enfant. Cependant le développement récent des techniques de dépistage génétique ainsi que celui des techniques d'imagerie indiquent que de nombreuses pancréatites, auparavant dites idiopathiques, étaient en réalité d'origine génétique ou malformative. L'objectif principal de l'étude est de recenser les cas de pancréatite et de définir la fréquence de survenue des différentes causes de pancréatite chez les 59 enfants suivis à l'hôpital universitaire de Saint-Luc sur une période de janvier 2014 à août 2016.Pour mener à bien ce mémoire, un tableau comparatif avec plusieurs données des patients a été réalisé. Les données démographiques (âge, sexe, origine ethnique, âge du premier épisode, consanguinité, présence d'un tabagisme passif) ont notamment été réponses. Concernant l'étiologie des pancréatites, elle a été recherchée en se basant sur la classification TIGAR-o. Les différentes complications et les différents examens complémentaires tels que l'échographie, le scanner, l'IRM, l'échographie endoscopique et/ou la CWR sont, quant à eux, répertoriés en fonction de chaque patient. Les résultats ont mis en évidence que plusieurs étiologies étaient souvent retrouvées chez un même patient. Chez 18.6% des enfants, plus de 2 causes conjointes étaient responsables d'une pancréatite. Dans l'étude, les étiologies retrouvées sont, par ordre de fréquence, une obstruction, une origine auto-immune, une origine métabolique et un traumatisme abdominal, une origine idiopathique, une mutation génétique et un toxique/médicament. Contrairement aux adultes, les facteurs environnementaux n'influencent pas la survenue de pancréatite chez l'enfant. Dans la grande majorité des cas (76.3%), aucune complication n'est survenue chez les enfants suivis en moyenne depuis 4 ans aux Cliniques Universitaires de Saint-Luc. La complication la plus fréquente est le pseudo kyste chez 17% patients.

Pancreatitis, concepts and classification : proceedings of the second international symposium, Marseille, March 28-30, 1984
Authors: --- ---
ISBN: 0444806504 9780444806505 Year: 1984 Volume: vol 642 Publisher: Amsterdam New York Oxford Excerpta Medica


Book
Autoimmune Pancreatitis
Authors: ---
ISBN: 9783642550867 3642550851 9783642550850 364255086X Year: 2015 Publisher: Berlin, Heidelberg : Springer Berlin Heidelberg : Imprint: Springer,

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Abstract

This book provides up-to-date information on all aspects of autoimmune pancreatitis, a unique form of pancreatitis characterized clinically by frequent presentation with obstructive jaundice and dramatic response to steroids, histologically by a lymphoplasmacytic infiltrate with fibrosis, and radiologically by pancreatic enlargement. Current concepts regarding the disease and its classification into subtypes 1 and 2 are explained, and clinical, serological, and histopathological findings are carefully described. Imaging features on all the relevant modalities are illustrated, covering both the pancreas and other involved organs. Current and emerging therapeutic strategies, including steroids, immunomodulatory drugs, and rituximab, are then discussed. The reader will find the book to be an excellent aid to the diagnosis of autoimmune pancreatitis and its differentiation from pancreatobiliary malignancies, as well as a clear guide to treatment.


Book
Prediction and Management of Severe Acute Pancreatitis
Authors: ---
ISBN: 9781493909711 1493909703 9781493909704 1493909711 Year: 2015 Publisher: New York, NY : Springer New York : Imprint: Springer,

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This volume provides a comprehensive summary of pancreatitis and its complications, with expert recommendations on prediction and management. The text thoughtfully summarizes the current prediction models for severe acute pancreatitis, including laboratory, clinical and imaging parameters, and highlights the relative advantages and disadvantages of several of these models. Evidenced-based guidelines into medical and surgical management of both the hospitalized and discharged patient are described, with recommendations from expert authors pertaining to various clinical situations. The volume also discusses complications of acute pancreatitis and their management, including the use of cutting-edge minimally-invasive therapies. Prediction and Management of Severe Acute Pancreatitis serves as the fundamental source for those interested in and treating this disease, including practicing gastroenterologists, surgeons, radiologists, intensivists, hospitalists and pathologists.

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