Pancreatic Injury Due To Blunt Abdominal Trauma in Children

Abstract

The diagnosis and management of pediatric pancreatitis is often difficult. Blunt abdominal trauma is one of the most common causes of pancreatitis in childhood. This is a review of patients with blunt pancreatic trauma. Medical records of all children with blunt pancreatic trauma who were admitted to our clinic between July 2007 and December 2017 were analyzed retrospectively. There were 17 patients (7 girls, 10 boys) with a mean age of of 9.89±2.57 years (range, 3-14 years). The time from trauma to admittance to the clinic was mean 17±21.43 days (range, 0-63 days). The mechanism of injury was bicycle injuries in 7 (41.66%), a fall from height in 6 (35.29%), motor vehicle accidents in 3 (17.64%), and a fall from a horse in 1 (5.88%). All patients had serum pancreatic amylase elevation on admission (average, 1002.71±966.36 IU/L; range, 116-3163 IU/L). All the childen were initially managed non-operatively. In 8 patients (52.94%) the traumatic pancreatitis was complicated by development of a pseudocyst. The average diameter of the pseudocyst was 11.5±3.45 cm. The pseudocysts were resolved in 5 cases with percutaneous ultrasonography-guided fluid drainage and the remaining 3 required open surgery (2 cystogastrostomy, 1 surgical drainage). The average length of hospital stay was 18±15.91 days (range, 2–48 days). There were no deaths and no complications in any patients. Non-operative management of traumatic pancreatitis in the absence of complete duct transection is safe in children. Percutaneous drainage of traumatic pancreatic pseudocysts can be used as an effective and useful treatment option.