Blunt pancreatic trauma in children

Baruch Klin, Ibrahim Abu-Kishk, Igor Jeroukhimov, Yigal Efrati, Eran Kozer, Efrat Broide, Yuri Brachman, Laurian Copel, Eitan Scapa, Gideon Eshel, Gad Lotan

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To report our experience with blunt pancreatic trauma in pediatric patients and evaluate several various management strategies. Methods: Ten children admitted over the last 10 years with pancreatic blunt trauma were included in the present series. Results: The average time from injury to hospital admission was 2.4 days. All injuries resulted from accidents: bicycle handlebar injuries (5), being kicked by a horse (2), falls from a height (2), and injury sustained during closure of an electric gate (1). Additional systemic and abdominal injuries were recorded in 7 patients. The amylase levels at the time of patient admission were normal in 3 patients, mildly raised in 4 patients, and elevated in 3 patients. Abdominal computed tomography was performed in 10 patients, ultrasonography in 5, and endoscopic retrograde cholangiopancreatography (ERCP) in 4. Pancreatic injuries comprised 4 grade I, 3 grade II, and 3 grade III injuries. Grade I and II injuries were successfully managed by conservative treatment. The 3 children with grade III trauma and pancreatic ductal injury in the neck (1), body (1), and tail (1) of the gland were surgically treated, having an uneventful postoperative stay of 8-14 days and no complications during the 1-year follow-up period. Conclusion: The present study supports early ERCP as an essential part of the initial patient evaluation when pancreatic transection is highly suspected.

Original languageEnglish
Pages (from-to)946-954
Number of pages9
JournalSurgery Today
Volume41
Issue number7
DOIs
StatePublished - Jul 2011
Externally publishedYes

Keywords

  • Gastrointestinal
  • Pancreas
  • Pediatric
  • Trauma

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