Diagnosis dan Tata Laksana Pankreatitis pada Anak

Authors

  • Nicodemus Dokter Umum, Pediatric Intensive Care Unit, Mayapada Hospital, Jakarta Selatan, Indonesia

DOI:

https://doi.org/10.36452/jkdoktmeditek.v28i3.2513

Keywords:

anak, diagnosis, pankreatitis akut, pankreatitis kronik, tata laksana

Abstract

Pankreatitis merupakan salah satu penyebab nyeri perut baik pada pasien dewasa maupun pada anak. Namun, seringkali hal ini dilupakan sebagai salah satu diagnosis banding nyeri perut pada anak terutama dengan episode berulang. Tujuan dari artikel ini adalah untuk meningkatkan kewaspadaan dan wawasan klinisi mengenai diagnosis dan tata laksana terkini dari pankreatitis pada anak. Metode penelusuran dengan mencari kepustakaan terkini yang relevan. Etiologi pankreatitis bersifat multifaktorial. Diagnosis pankreatitis  harus dilakukan dengan tepat dan cepat agar pasien bisa mendapat tata laksana yang adekuat. Tata laksana utama meliputi pemberian cairan, analgetik, nutrisi dini, hingga tindakan Endoscopic Retrograde Cholangiopancreatography (ERCP) dan operatif apabila diperlukan.  Tata laksana yang terlambat ataupun tidak adekuat dapat menyebabkan pankreatitis berlanjut menjadi kronik dan dapat menimbulkan berbagai komplikasi. Oleh sebab itu, pankreatitis perlu dipikirkan sebagai salah satu diagnosis banding nyeri perut pada anak.

References

Sellers ZM, MacIsaac D, Yu H, Dehghan M, Zhang KY, Bensen R, et al. Nationwide trends in acute and chronic pancreatitis among privately insured children and non-elderly adults in the United States, 2007-2014. Gastroenterology. 2018;155(2):469–78.

Poddar U, Yachha SK, Borkar V, Srivastava A, Kumar S. A report of 320 cases of childhood pancreatitis: increasing incidence, etiologic categorization, dynamics, severity assessment, and outcome. Pancreas. 2017;46(1):110–5.

Sweeny KF, Lin TK, Nathan JD, Denson LA, Husain SZ, Hornung L, et al. Rapid progression of acute pancreatitis to acute recurrent pancreatitis in children. J Pediatr Gastroenterol Nutr. 2019;68(1):104–9.

Oracz G, Wejnarska K, Kolodziejczyk E, Jaroslaw Kl. Pediatric acute and chronic pancreatitis: increase in incidence or increasing awareness? Pancreas. 2017;46(6):55–6.

Pant C, Sferra TJ. Emergency department visits and hospitalizations in children with chronic pancreatitis in the United States. J Pediatr Gastroenterol Nutr. 2015;61(1):568–70.

Kumar S, Ooi CY, Werlin S, El-Haija MA, Barth B, Bellin MD, et al. Risk factor associated with pediatric acute recurrent and chronic pancreatitis: lessons from INSPIRE. JAMA Pediatr. 2016; 170(6):562-9.

Gonska T. Genetic predisposition in pancreatitis. Curr Opin Pediatr. 2018;30(5):660–4.

Gariepy CE, Heyman MB, Lowe ME, Pohl JF, Werlin SL, Wilschanski M, et.al. Causal evaluation of acute recurrent and chronic pancreatitis in children: consensus from the INSPIRE Group. J Pediatr Gastroenterol Nutr. 2017;64(1):95-103.

Giefer MJ, Lowe ME, Werlin SL, Zimmerman B, Wilschanski M, Troendle D, et al. Early-onset acute recurrent and chronic pancreatitis is associated with PRSS1 or CTRC gene mutations. J Pediatr. 2017;186:95–100.

Hegyi P, Wilschanski M, Muallem S, Lukacs GL, Sahin-toth M, Uc A, et al. CFTR: a new horizon in the pathomechanism and treatment of pancreatitis. Rev Physiol Biochem Pharmacol. 2016;170:37–66.

Parniczky A, El-Haija MA, Husain S, Lowe M, Oracz G, Sahin-toth M, et al. EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis. Pancreatology. 2018; 18(2):146-160.

Morinville VD, Lowe ME, Ahuja M, Barth B, Bellin MD, Davis H, et al. Design and implementation of insppire (International Study Group of Pediatric Pancreatitis: in Search for a Cure). J Pediatr Gastroenterol Nutr. 2014;59(3):360–4.

El-Haija M, Kumar S, Quiros JA, Balakrishman K, Barth B, Bitton S, et al. Manangement of acute pancreatitis in the pediatric population : a clinical report from the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition Pancreas Committee. J Pediatr Gastroenterol Nutr. 2018;66(1):159-176.

Coffey MJ, Nightingale S, Ooi CY. Diagnosing acute pancreatitis in children: what is the diagnostic yield and concordance for serum pancreatic enzymes and imaging within 96 h of presentation? Pancreatology. 2014;14(4):251-6.

Morinville VD, Husain SZ, Bai H, Barth B, Alhosh R, Durie PR et al. Defifinitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012;55(3):261–5.

Barral M, Taouli B, Guiu B, Koh DM, Luciani A, Manfredi R, et al. Diffusion-weighted MR imaging of the pancreas: current status and recommendations. Radiology. 2015;274(1):45–63.

Hwang JY, Yoon HK, Kim KM. Characteristics of pediatric pancreatitis on magnetic resonance cholangiopancreatography. Pediatr Gastroenterl Hepatol Nutr. 2015;18(2):73-84.

Gordon K, Conway J, Evans J, Petty J, Fortunato JE, Mishra G. Eus and eus-guided interventions alter clinical management in children with digestive diseases. J Pediatr Gastroenterol Nutr 2016;63(2):242-6.

Wu BU, Hwang JQ, Gardner TH, Repas K, Delee R, Yu S, et al. Lactated ringer's solution reduces systemic inflflammation compared with saline in patients with acute pancreatitis. Clin Gastroenterol Hepatol. 2011;9(8):710-7.

Szabo FK, Fei L, Cruz LA, El-Haija M. Early enteral nutrition and aggressive fluid resuscitation are associated with improved clinical outcomes in acute pancreatitis. J Pediatr 2015;167(2):397–402.

Poropat G, Giljaca V, Hauser G, Stimac D. Enteral nutrition formulations for acute pancreatitis. Cochrane Database Syst Re. 2015;3:CD010605.

El-Haija M, Wilhelm R, Heinzman C, Siqueira BN, Zou Y, Fei L, et al. Early enteral nutrition in children with acute pancreatitis. J Pediatr Gastroenterol Nutr. 2016;62(3):453-6.

El-Haija M, Uc A, Werlin SL, Freeman AJ, Georgieva M, Jojkic-Pavkov D, et al. Nutritional considerations in pediatric pancreatitis: a position paper from the NASPHAN Pancreas Committee and ESPHAN Cystic Fibrosis/Pancreas Working Group. J Pediatr Gastroenterol Nutr. 2018;67(1):131-43.

Freeman AJ, Maqbool A, Bellin MD, Goldschneider KR, Grover AS, Hartzell C, et al. Medical management of chronic pancreatitis in children: a position paper by North American Society for pediatric gastroenterology, hepatology, and nutrition pancreas committee. J Pediatr Gastroenterol Nutr. 2021;72(2):324-40.

Wilson PR. Multidisciplinary management of chronic pain. A practical guide for clinicians. Pain Med 2016;17:1376–8.

Sheehy KA, Lippold C, Rice AL, Nobrega R, Finkel JC, Quezado ZM. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study. J Pain Res. 2017;10:787–95.

Garah J, Rosen I, Shaoul R. Transient exocrine pancreatic insuffificiency in children: an existing entity? J Pediatr Gastroenterol Nutr. 2019;68(4):574–7.

Schwarzenberg SJ, Uc A, Zimmerman B, Wilschanski M, Wilcox CM, Whitcomb DC, et al. Chronic pancreatitis: pediatric and adult cohorts show similarities in disease progress despite different risk factors. J Pediatr Gastroenterol Nutr. 2019;68(4):566–73.

Uc A, Perito ER, Pohl JF, Shah U, El-Haija M, Barth B, et al. International Study Group of Pediatric Pancreatitis: In Search for a CuRE Cohort Study: Design and Rationale for INSPPIRE 2 from the consortium for the study of chronic pancreatitis, diabetes, and pancreatic cancer. Pancreas. 2018;47(10):1222–8.

American Diabetes Association. Classifification and diagnosis of diabetes: standards of medical care in diabetes-2019. Diabetes Care. 2019;42(Suppl 1):S13–28.

Sacco-Casamassima MG, Goldstein SD, Yang J, Gause CD, Abdullah F, Meoded A, et al. The impact of surgical strategies on outcomes for pediatric chronic pancreatitis. Pediatr Surg Int. 2017;33(1):75-83.

Bellin MD, Forlenza GP, Majumder K, Berger M, Freeman ML, Beilman GJ, et al. Total pancreatectomy with islet autotransplantation resolves pain in young children with severe chronic pancreatitis. J Pediatr Gastroenterol Nutr. 2017;64(3):440-45.

Published

2022-09-01

How to Cite

Nicodemus. (2022). Diagnosis dan Tata Laksana Pankreatitis pada Anak. Jurnal Kedokteran Meditek, 28(3), 347–354. https://doi.org/10.36452/jkdoktmeditek.v28i3.2513

Issue

Section

Tinjauan Pustaka