Pediatric Acute Pancreatitis: A Seven-Year Cohort Study of Etiology, Severity, and Outcomes in Pakistan

Objective: To identify the etiology, assess the severity, and evaluate the outcomes of acute pancreatitis (AP) in children admitted to a tertiary care hospital. Methods: A retrospective medical record review was conducted at the Department of Pediatrics and Child Health of a tertiary care center from January 2018 to December 2024 after obtaining approval from the institutional ethical review board. The study included all children aged one month to 18 years with physician-diagnosed AP who presented during the study period. Medical records were reviewed to obtain relevant demographic and clinical information. The primary outcome measures included the etiology of pediatric AP, disease severity (mild, moderate, or severe), clinical presentation, incidence of complications during hospitalization, recurrence, and in-hospital mortality. Results: In a study of 112 children with AP, 80 (71%) had mild disease, and 32 (29%) had moderate to severe cases. Idiopathic etiology was the most common, 79 (70.5%), whereas gallstone-related pancreatitis accounted for 9 (11%) in older children (11-18 years, n=81). No factors were independently linked to disease severity, and about 67 (60%) experienced recurrent pancreatitis (based on multiple documented episodes), though serious complications and mortality were rare. Conclusion: In this pediatric cohort of AP from a low-resource country, idiopathic pancreatitis was the most common etiology. Most cases were mild, and systemic complications were rare, with no factors independently predicting disease severity.