Management of blunt pancreatic trauma in children

Abstract

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. The most common complications are the formation of pancreatic fistulae, pancreatitis and the development of pancreatic pseudocysts, which usually present several weeks after injury. The nonoperative management of minor pancreatic injury is well accepted; however, the treatment of more serious pancreatic injuries with capsular, ductal or parenchymal disruption in pediatric patients remains controversial. Based on the data presented in this literature review, although children with pancreatic injuries (without ductal disruption) do not appear to suffer increased morbidity following conservative management, patients with ductal disruption may benefit from operative intervention.

ERCP with stenting of Traumatic Pancreatic duct transection: A case report

“…[4] Most common etiology is bicycle handle bar injury. [5] Diagnosis involves high index of suspicion, as symptoms are often insidious in onset and serum enzyme markers (amylase and lipase) usually do not correlate with severity of injury and may be normal in proportion of injuries.…”

“…Cited rationale is removal of activated proteolytic enzymes that can lead to formation of fistulae, abscesses, and pseudocysts. [4] Potential advantages of ERCP as an adjunct to non-operative management may include reduced rates of pseudocyst formation, shorter hospital stay, and quicker return to oral intake. Common potential risks of non-operative management are pancreatic duct strictures, atrophy of the distal duct despite intervention, post-ERCP pancreatitis, and need for future intervention.…”

Stumpe pancreasskader hos barn

“…2). We excluded a pure literature study (6) and a literature study that lacked a methods section (7). A complementary search for the period from 20 October 2015 to 20 October 2016 resulted in the inclusion of two additional articles (8,9) (Fig.…”

“…In up to half of the patients, grade III and IV injuries can be treated with early drainage, with or without ERCP and stent insertion. The risk of further interventions is greater with these measures, and future surgery will nonetheless often be necessary (7,16,22). Up to half of the children treated with observation alone will develop pseudocysts.…”

Gastrointestinal considerations related to youth sports and the young athlete

“…The majority of abdominal injuries in children are due to blunt abdominal trauma (27). Abdominal injuries in athletes can range in severity from a mild abdominal strain to significant organ rupture and internal bleeding.…”