Gastroenterologìa (Nov 2017)
Clinical and sonographic features of the pancreatic steatosis in children with overweight and obesity
Abstract
Background. Early diagnosis of pancreatic steatosis is essential for the early metabolic risk detection and chronic gastroenterological morbidity reduction. The purpose was to examine the clinical and sonographic features of pancreatic steatosis in children with overweight and obesity. Materials and methods. The presence of pancreatic steatosis was determined by ultrasonography in 53 children with functional disorders of the gastrointestinal tract. Division in groups was performed on the basis of pancreatic steatosis and obesity/overweight presence: group 1 consisted of 24 patients with pancreatic steatosis and obesity/overweight, group 2 included 18 children with obesity/overweight with no signs of pancreatic steatosis, the control group consisted of 11 patients without pancreatic steatosis and with normal weight. Results. The clinical picture in children with pancreatic steatosis may be explained by concomitant gastroenterological diseases, but 29.1 % of group 1 patients complained of pain in the left upper quadrant. Patients with steatosis often complained of nausea (58.3 %), flatulence (45.8 %) in comparison to patients who had normal weight, but the significance of the differences was not sufficient. Group 1 patients often reported pain on palpation of the intestine compared with other 2 groups. Pain on palpation in pancreatic points was significantly higher in group 1 patients (54.1 %) compared to group 3. Increased liver echogenicity was found 2.4 times more often in group 1 patients compared with group 2. In particular, changes in liver grains were three times more common in patients with steatosis (p < 0.05), as compared to the obese patients without steatosis and to the children with normal weight. Pancreatic changes in steatosis manifested not only by the changes in echogenicity, but also by fuzzy contours of the pancreas, increased grain (65.5 %) in almost half of patients (45.8 %). Gallbladder volume and wall thickness were significantly higher in the group of children with steatosis compared to the control group. Symptoms of biliary sludge were twice more common in children with steatosis compared to children without steatosis and 4 times more likely than in children with normal weight (43.87 % in group 1; 21 % in group 2, and 9 % in group 3). Conclusions. Thus, clinical and sonographic features in patients with steatosis indicate the possibility of inflammatory changes in the parenchyma associated with systemic inflammation due to steatosis and concomitant diseases of the gastrointestinal tract.
Keywords
