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OBJECTIVE: To describe the clinical and pathological features acute pancreatitis identified at autopsy, as defined by the presence of aseptic necrosis of pancreatic parenchyma with fat necrosis and saponification of adjacent tissues. MATERIALS AND METHODS: We identified and reviewed all cases with the pathology diagnosis of acute pancreatitis in our autopsy records of 7250 studies performed from 1971 to 2011. RESULTS: Forty-four cases were identified, most of them in the last decade, suggesting an increasing frequency of this condition. Only in a single case was pancreatitis the primary disease, in a child dying after a scorpion bite. All other cases were associated with an underlying condition, mostly cancer or systemic lupus erythematosus. The etiology was drug related in most cases. A typical clinical picture was present in only 11 patients (25%). The clinical diagnosis of acute pancreatitis was established in 7 cases. CONCLUSION: Acute pancreatitis in children is underdiagnosed. The definitions and clinical criteria as referred in the literature overlook the characteristics of a population with subclinical pancreatitis. Assay of pancreatic enzymes in all patients with risk factors may lead to the timely identification of this condition.

Pancreatitis aguda en niños. Una perspectiva desde la autopsia