Paediatric pancreatic trauma: A review of the literature and results of a multicentre survey on patient management:

Westgarth-Taylor, Chris; Loveland, Jerome

doi:10.7196/samj.8920

Cited by 11 publications

(18 citation statements)

References 29 publications

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“…5,[17][18][19][20][21][22] Further, a multicentre study in adults 23 and a multicentre study in children 16 and several larger single, dual, or multi-centre cohorts were included. [24][25][26][27][28][29][30][31][32][33][34]…”

Section: Resultsmentioning

confidence: 99%

“…14,15 The most frequent complication associated with non-operative management is development of a pseudocyst which occurs in almost 15-20% of patients, but about half to two-thirds of these can be handled non-operatively and recover without further operative management. 14,16,18 Notably, it is recognized that there is high variability between surgeons in terms of choice of management of pancreas injury in children, particularly for highgrade injuries, 28,29 and there is considerable heterogeneity in the case series reported. 28 This is largely reflected in variation in outcomes such as time to enteral nutrition and length of hospital or intensive care stay, but not in mortality.…”

Section: Management Of Pancreatic Injury In Childrenmentioning

confidence: 99%

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Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

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Section: Resultsmentioning

confidence: 99%

Section: Management Of Pancreatic Injury In Childrenmentioning

confidence: 99%

Clinical update on management of pancreatic trauma

Søreide

Weiser

Parks

2018

HPB

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“…In 2014, a questionnaire assessing therapeutic strategies for grade III pancreatic injuries in various paediatric units in four different countries revealed that if the patient presented 6 hours post injury, 10 surgeons would do a laparotomy, 8 would treat non-operatively and 3 would carry out endoscopic duct stenting via ERCP. If the same child with grade III injury were to be assessed 6 days post injury by the same surgeons, 4 would operate, 13 would treat conservatively and 4 would choose ERCP (46). Supporters of early surgery and resection are basing their preference on prompt eradication of the source of potential complications.…”

Section: Special Aspects Of Paediatric Special Aspects Of Paediatric mentioning

confidence: 99%

Diagnosis and Management of Blunt Pancreatic Trauma

Kollár

Molnár

Zsoldos

et al. 2018

SGO

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Introduction: Blunt or penetrating pancreatic trauma represents only 0.2-2% of all trauma cases and approximately 3-12% of all abdominal injuries. While treatment protocol debates of other intra-abdominal and thoracic organ injuries seem to reach comforting conclusions, satisfying evidence-based recommendations regarding the pancreas have not been released yet. However, high grade trauma of the pancreas can lead to substantial morbidity and mortality. The question is, when and how to treat it conservatively or operatively. Objectives/Methods: This study is a review of contemporary literature on children and adult pancreatic trauma management strategies and findings. The purpose is to evaluate current classifications and the efficacy of subsequent non-operative and operative treatments. We list the established grading systems starting from physical examination, imaging diagnosis, to indications for surgery or conservative management, followed by post-treatment morbidity and mortality rates. Conclusions: Current operative or non-operative management strategies are not based on randomized -or even, in fact, on prospective -clinical trials. Most of the available publications demonstrate small retrospective patient cohorts and expert opinions. To date, no convincing high level (at least Level III) evidence-based recommendations have been published in terms of treatment of these injuries. There is a general agreement, that the injury of the main pancreatic duct is the thin red line, dividing conservative and operative strategies. Low grade pancreatic injury can be treated conservatively not significantly different from protocols developed for mild pancreatitis of other origin. Pancreatic duct damage in adults requires either minimal invasive intervention or exploration and reconstruction/resection via laparotomy. Treatment strategies of high grade paediatric pancreatic injuries remain controversial. Associated organ injuries can mask the symptoms of pancreatic trauma. Missed main pancreatic duct injuries pose a clinically challenging situation with serious complications and considerable mortality. Pancreatic injury in polytrauma poses the highest risk. Present perspectives for survival of pancreatic injury as mono trauma varies between 95-100%, while as a part of polytrauma, the mortality rate is as high as 30-35%. Multicentre prospective, randomized clinical trials would be ideal to support optimal decision making. Heterogeneity of cases and relative rarity of the pathology makes the creation of such a database highly unlikely.Pancreatic injury makes up a relatively small proportion of trauma cases: the pancreas is affected in 0.2-2% of all trauma patients and in 2-12% of all

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“…Spesifik, direkt bulgular, pankreasta boyut artışı, laserasyon (fokal lineer kontrast tutmayan alan), inhomojen kontrast tutulumu, fragmantasyon ve hematom olarak görülebilir. İndirekt, nonspesifik bulgular, peripankreatik yağ planlarında silinme, laserasyonla ilişkili peripankreatik sıvı, splenik ven ve pankreas arasında sıvı, hemoraji, sol anterior pararenal fasiyada kalınlaşma, komşu yapılarda eşlik eden yaralanmalar olarak sayılabilir [1,4,[18][19][20][21][22].…”

Section: Pankreas Yaralanmalarıunclassified

Abdominal Travma

Sarsilmaz¹,

Kocakoç²

2016

Trd Sem

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Paediatric pancreatic trauma: A review of the literature and results of a multicentre survey on patient management:

Cited by 11 publications

References 29 publications

Clinical update on management of pancreatic trauma

Clinical update on management of pancreatic trauma

Diagnosis and Management of Blunt Pancreatic Trauma

Abdominal Travma

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