TY - JOUR
T1 - Blunt pancreatic trauma in children
AU - Klin, Baruch
AU - Abu-Kishk, Ibrahim
AU - Jeroukhimov, Igor
AU - Efrati, Yigal
AU - Kozer, Eran
AU - Broide, Efrat
AU - Brachman, Yuri
AU - Copel, Laurian
AU - Scapa, Eitan
AU - Eshel, Gideon
AU - Lotan, Gad
PY - 2011/7
Y1 - 2011/7
N2 - 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.
AB - 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.
KW - Gastrointestinal
KW - Pancreas
KW - Pediatric
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=79960331391&partnerID=8YFLogxK
U2 - 10.1007/s00595-010-4369-y
DO - 10.1007/s00595-010-4369-y
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AN - SCOPUS:79960331391
SN - 0941-1291
VL - 41
SP - 946
EP - 954
JO - Surgery Today
JF - Surgery Today
IS - 7
ER -