Changing incidence of acute pancreatitis: 10‐year experience at the Royal Children's Hospital, Melbourne

The aim of this study was to assess the incidence and etiology of acute pancreatitis at a major pediatric referral center in Australia.A 10-year retrospective audit was conducted at The Royal Children's Hospital, Melbourne, Australia. All patients from 1993 and 2002 with a serum lipase level greater than three times the upper reference range and a history consistent with acute pancreatitis were included.During the 10-year period, 279 confirmed cases of acute pancreatitis were identified. The median age at presentation was 10 years (range, 0.2-15.9). In 209 (74.9%) patients, a likely cause of acute pancreatitis was found, including trauma (36.3%), systemic disease (22.2%), metabolic (5.8%), biliary (5.4%), drugs (3.2%), or viral illness (2.2%). In the remaining 70 (25.1%) cases, the pancreatitis was deemed idiopathic. Comparing data from 1993 to 1997 with data from 1998-2002, there was a significant increase in the annual incidence of pancreatitis (24.6 +/- 2.3 vs 31.2 +/- 6 cases per year; P = 0.04). A linear regression analysis showed a strong association between the incidence and the year of diagnosis (r(2) = 0.5775, P = 0.01). This increase was mainly due to a significant rise in idiopathic disease (r(2) = 0.83, P = 0.0002) and systemic disease (r(2) = 0.41, P = 0.048), whereas the incidence of other causes of acute pancreatitis remained unchanged.The incidence of acute pancreatitis in children has increased significantly over the past decade. The increase was greatest in children with idiopathic pancreatitis. It remains unclear whether this reflects a true incidence increase or improved clinical awareness.