Introduction: The goal of corticosteroid therapy is to maximize efficacy, minimize potential systemic side effects, and improve patient adherence. Factors that will potentially improve adherence to treatment and differentiate the intranasal corticosteroids are dosing regimens, patient preference and cost effectiveness.

Keywords: Blunt trauma abdomen; Pancreatic injury; Non operative management Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury is the fourth most common solid organ injury, following injuries to the spleen, liver and kidneys [1]. Pancreatic injury is a rare but severe complication occurring in 2-5% of blunt abdominal traumas. It is most often caused by compression of the gland against the lumbar part of the vertebral column. Due to contusion, the pancreas often ruptures completely [2,3]. Non-surgical management of minor pancreatic injury is well accepted, but the management of serious pancreatic injury in children remains controversial [4]. Pancreatic injuries often induce severe complications. Some centers recommend an aggressive surgical approach to reduce the incidence of pseudocyst formation and to prevent greater morbidity and prolonged hospitalization. Others advocate that non-surgical management of pancreatic injury in children leads to a good clinical outcome. Early diagnosis and adequate therapy of pancreatic trauma are essential for the prevention of complications. Correct diagnosis can be difficult in blunt abdominal trauma, especially in the case of isolated pancreatic injury, because retroperitoneal lesions do not have any specific symptoms [4,5]. We evaluated the data of 2 cases of pancreatic injury in childhood presented at our department. Case 1A 4 year old male child presented to our hospital with history of tractor door fall on his abdomen on 10/8/2012, later he complained of pain in abdomen and distension of abdomen for which he was shown at local hospital later he was referred to our institute. On admission, child had no history of hematemesis, malena and hematuria.His investigations were as follows Hemoglobin-8.7 gm%, Hematocrit-26%Liver function test-SGOT-51 IU/L, SGPT-340 IU/L, Serum lipase -285 IU/l, serum amylase-321 IU/l on admission Serum amylase-402 IU/l, Serum Lipase-458 IU/l after two days of admission Serum Ca-9.4 mg%, RBS-95 mg%, serum urea-34 mg%, serum creatinine-0.8 mg% He had undergone Ultrasonography of abdomen; report stated minimal intraperitoneal free fluid, with no evidence of solid organ injury on the day of injury. In view of further evaluation, child was subjected to CECT (Contrast Enhanced Computerized Tomography) of abdomen, which revealed an irregular hypodense non enhancing area measuring 5.3 cm×9.0 cm in the left lobe of liver adjacent to falciform ligament with sub capsular collection. Irregular hypodense, non enhancing linear area measuring 2.0 cm was seen in the body of pancreas along its transverse axis and all other solid organs were normal. Minimal intraperitoneal fluid in the pelvis and general peritoneal cavity was also observed. The fluid aspirated from the peritoneal cavity revealed amylase -1347 IU/l, protein-4.2 gm%, LDH-220 IU/L, cell count-6800 cells/mm 3 , with predominant lymphocytes. On the 11 th day of admission, the child had abdominal distension and fever; hence review USG (Ultrasonography...