Text Box: THE CLINICAL STUDY ON CHILDREN ACUTE PANCREATITIS INDUCE BY L-ASPARAGINASE Shi Huiwen, Wu Min-yuan, Jin Ling et al Beijing Children’s Hospital, Beijing, China Objective: Acute pancreatitis in children acute lymphoblastic leukemia (ALL) has been associated with L-Asparaginase (L-Asp) chemotherapy. Its clinical features are studied in order to diagnose and treat it early. Method: The clinical characteristics of 19 case L-Asp–induced acute pancreatitis are analyzed, which were among the 675 cases who made use of L-Asp during the last 5 years. Result: The incidence of L-Asp–induced acute pancreatitis in children ALL was 2.81%. The clinical manifestations are gastralgia accompanied by nausea and vomiting, fever, bloated and shock. The firstly-occurred symptom is mainly gastralgia, secondly shock. There are liver damage, peritonitis, and infection. For the hematological examination, there are increase in serum amylase, Hyperglycemia, hyponatremia, hypocalcemia, hypoproteinemia, acidosis, renal feature and abnormal of coagulation. 16 cases of 18 cases examined by ultrasonography or CT were abnormal. It is seemed that B ultrasonography is more sensitive. 13 cases were recovered, only 2 cases of them were belong to necrotizing, hemorrhagic pancreatitis. The other 7 ones of this type died from shock. Conclusion: The L-Asp- induced acute pancreatitis isn’t common, but very severe, with high mortality, especially necrotizing, hemorrhagic pancreatitis. It is possible to make early diagnosis according to L-Asp administration history, gastralgia and/or shock together with increased s-amylase and imaging examination. The three important treatment measures are rescuing shock, restraining secretion of pancreatitic enzyme and rapid operation. 1085