Stumpe pancreasskader hos barn

Antonsen, Ingrid; Berle, Veronica; Søreide, Kjetil

doi:10.4045/tidsskr.16.0888

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…10 Given the infrequency of pancreatic traumas, management recommendations and strategies rely on consensus guidelines with limited levels of evidence. [10][11][12][13][14][15] The severity of pancreatic trauma can range from mild symptoms resembling pancreatitis to severe damage involving the pancreatic parenchyma, occasionally leading to complete gland section. Therapeutic options include nonoperative conservative management, surgical treatment, and endoscopic interventions.…”

Section: Discussionmentioning

confidence: 99%

“…Proton pump inhibitors were administered to prevent stress ulcers, and the volume status was restored. The administration of somatostatin or its synthetic analogs was also carried out to inhibit pancreatic exocrine secretion and reduce postoperative morbidity in patients with pancreatic trauma, 13,14 although some authors and the consensus of the Eastern Association for the Surgery of Trauma in 2017 questioned the beneficial effects of somatostatin. [12][13][14][15][16] After blunt pancreatic trauma, when canal involvement is confirmed, endoscopic treatment may be considered for hemodynamically stable patients without other associated injuries.…”

Section: Discussionmentioning

confidence: 99%

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Case series: Management and outcomes of five cases of blunt and open pancreatic trauma

Belhadj,

Saidani,

Touati

et al. 2024

F1000Res

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Introduction Pancreatic trauma is notably less frequent than injuries affecting other solid organs, such as the liver or spleen. Despite their infrequency, pancreatic injuries can pose significant risks, with mortality rates ranging from 5 to 30% and morbidity rates reaching 50%. Managing such injuries remains contentious because of the anatomical complexity, lesion extent, and close proximity to neighboring organs. Methods Our study aimed to delineate the clinical and biological characteristics of pancreatic trauma and specify diagnostic and therapeutic modalities. This study was conducted retrospectively from 2010 to 2021 at Mahmoud El Matri Hospital’s General Surgery Department in Ariana, TUNISIA, and included five cases of blunt and open pancreatic trauma. Results Although rare, pancreatic injuries can lead to serious consequences, prompting the development of a diverse array of therapeutic options. Pancreatic trauma presents a complex clinical challenge, necessitating a comprehensive approach that considers various factors, such as injury severity, anatomical location, and patient condition. Advanced imaging techniques, including computed tomography (CT) scanning, Wirsung-MRI, and ERCP, aid in the accurate diagnosis and assessment of canal involvement. Conservative management was considered for cases with limited canal rupture, whereas endoscopic treatments showed promise for hemodynamically stable cases. Surgical interventions, such as duodenopancreatectomy, are reserved for exceptional cases with severe injuries. Conclusion Pancreatic trauma requires a comprehensive approach that considers factors such as injury severity, anatomical location, and patient condition. Ongoing research and collaboration are vital for refining pancreatic trauma management and proposing guidelines for facilitating decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case series: Management and outcomes of five cases of blunt and open pancreatic trauma

Belhadj,

Saidani,

Touati

et al. 2024

F1000Res

View full text Add to dashboard Cite

show abstract

“…Abdominal USS is typically the first modality utilized. Depending on the findings of the USS, further evaluation can be conducted using CT and/or magnetic resonance imaging [3]. Early detection through an initial CT scan, combined with other imaging modalities and follow-up scans, may enhance the prognosis [6].…”

Section: Discussionmentioning

confidence: 99%

“…Studies also indicate that over 75% of pancreatic injuries in children re-sult from blunt trauma, most commonly caused by handlebar injuries or seatbelts. It is crucial to recognize that diagnosing blunt pancreatic injuries can be challenging and requires a high degree of suspicion for proper management [3]. Furthermore, pancreatic injuries can range from minor contusions to severe damage involving the PD [4].…”

Section: Introductionmentioning

confidence: 99%

Blunt abdominal trauma resulting in pancreatic injury in a pediatric patient in Australia: a case report

Dev,

Kikiros

2023

J Trauma Inj

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Pancreatic trauma from a blunt injury is fairly uncommon in the pediatric population. Furthermore, such trauma with associated disruption of the pancreatic duct (PD) is even less prevalent and is associated with high morbidity and mortality. Pancreatic injuries in the pediatric population are often missed and hence require a thorough workup in children presenting with any form of abdominal injury. This case report describes a young boy who presented with abdominal pain and did not initially inform medical staff about any injury. For this reason, his initial provisional diagnosis was appendicitis, but he was later found to have transection of the pancreas with injury to the PD on imaging. The management of such injuries in pediatric patients often poses a challenge due to a lack of pediatric physicians trained to perform interventions such as endoscopic retrograde cholangiopancreatography. Furthermore, such interventions carry a higher risk when performed on children due to the smaller size of their pancreatic ducts. As a result, our patient had to be transferred to an adult center to undergo this procedure. Thus, maintaining a high degree of suspicion, along with a detailed history and examination, is crucial for the early diagnosis and management of pancreatic injuries.

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Current status and management of pancreatic trauma with main pancreatic duct injury: A multicenter nationwide survey in Japan

Ando

Okano

Yasumatsu

et al. 2021

J Hepato Biliary Pancreat

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Background: Pancreatic trauma is reportedly associated with high morbidity and mortality. Main pancreatic duct (MPD) injury is critical for treatment. Methods: As a study project of the Japanese Society for Abdominal Emergency Medicine (JSAEM), we collected the data of 163 patients with pancreatic trauma who were diagnosed and treated at JSAEM board-certified hospitals from 2006 to 2016. Clinical backgrounds, diagnostic approaches, management strategies, and outcomes were evaluated. Results: Sixty-four patients (39%) were diagnosed as having pancreatic trauma with MPD injury that resulted in 3% mortality. Blunt trauma and isolated pancreatic injury were independent factors predicting MPD injury. Nine of 11 patients with MPD injury who were initially treated nonoperatively had serious clinical sequelae and five (45%) required surgery as a secondary treatment. Among all cases, the detectability of MPD injury of endoscopic retrograde pancreatography (ERP) was superior to that of other imaging modalities (CT or MRI), with higher sensitivity and specificity (sensitivity = 0.96; specificity = 1.0). Conclusions: Acceptable outcomes were observed in pancreatic trauma patients with MPD injury. Nonoperative management should be carefully selected for MPD injury. ERP is recommended to be performed in patients with suspected MPD injury and stable hemodynamics. K E Y W O R D S endoscopic retrograde pancreatography, main pancreatic duct injury, management, nationwide survey, pancreatic trauma This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Stumpe pancreasskader hos barn

Cited by 8 publications

References 37 publications

Case series: Management and outcomes of five cases of blunt and open pancreatic trauma

Case series: Management and outcomes of five cases of blunt and open pancreatic trauma

Blunt abdominal trauma resulting in pancreatic injury in a pediatric patient in Australia: a case report

Current status and management of pancreatic trauma with main pancreatic duct injury: A multicenter nationwide survey in Japan

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