Abstract
Chronic relapsing pancreatitis in adolescence is a most uncommon clinical problem and has received minimal separate recognition in the literature. Adolescence is an age when the causes of the disease, which may operate from birth, overlap with the major etiological factors in the generality of pancreatitis in adult life. A personal series of 32 patients with pancreatitis, aged 11–20 years, is reported. Twenty-four followed a chronic relapsing course. There was, therefore, a marked reversal of the normal preponderance of acute over chronic relapsing cases. Those with underlying biliary disease, and the group in whom no etiological factors could be identified, ran an unexpectedly severe and troublesome course. This, coupled with the reversal of the acute versus chronic disease ratio, raises the question as to whether adolescent pancreatitis is a distinct subgroup in the overall spectrum of this disease.
Résumé
La pancréatite chronique récidivante chez l'adolescent ne se rencontre pas souvent et a reçu peu d'attention dans la littérature médicale à ce jour. Pour cette population, les causes de pancréatite, parfois déjà présentes dès la naissance, se confondent ensuite avec celles de l'âge adulte. Nous rapportons une série personnelle de 32 patients d'âge 11 à 20 ans, ayant une pancréatite. Vingt-quatre avaient une évolution récidivante; la proportion de pancréatites récidivantes était donc plus impotante que d'habitude dans cette population. L'évolution a été plus grave et émaillée de complications chez les patients avec une cause biliaire ou chez ceux où aucune cause n'avait été retrouvée. Ces données, ainsi que la fréquence anormalement élevée des formes chroniques par rapport aux formes aiguës, soulèvent la question suivante: savoir si la pancréatite de l'adolescent n'est pas un sous-groupe distinct dans la gamme de la maladie.
Resumen
La pancreatitis crónica recidivante en la adolescencia representa un problema clínico muy poco común y ha merecido mínimo reconocimiento en la literatura. Corresponde a un rango de edad en el cual las causas de enfermedad, que pueden operar desde el nacimiento, se sobreponen a los principales factores etiológicos de la generalidad de las pancreatitis de la edad adulta. Se informa una serie personal de 32 pacientes con pancreatitis con edades entre los 11 y los 20 años. Veinticuatro exhibieron un curso recidivante, lo cual significa una notoria inversión de la normal preponderancia de los casos agudos sobre los crónicos recidivantes. Estos, acompanados de enfermedad biliar subyacente, y el grupo en el cual no se logró identificar factores etiológicos, desarrollaron un curso inesperadamente severo y complicado, Todo esto, unido a la reversión de la proporción de casos agudos versus enfermedad crónica, plantea el interrogante de si là pancreatitis del adolescente representa un subgrupo definido, una entidad clínica separada, dentro del espectro general de la enfermedad.
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Trapnell, J.E. Management of chronic relapsing pancreatitis in adolescents. World J. Surg. 14, 48–52 (1990). https://doi.org/10.1007/BF01670545
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DOI: https://doi.org/10.1007/BF01670545