Pediatric Surgery International

, Volume 30, Issue 11, pp 1107–1110 | Cite as

Multi-institutional experience with penetrating pancreatic injuries in children

  • Hanna Alemayehu
  • Kuojen Tsao
  • Mark L. Wulkan
  • Saleem Islam
  • Robert T. Russell
  • Todd A. Ponsky
  • Daniel C. Cullinane
  • Adam Alder
  • Shawn D. St. Peter
  • Corey W. IqbalEmail author
Original Article



Penetrating pancreatic injuries in children are uncommon and are not well described in the literature. We report a multi-institutional experience with penetrating pancreatic injuries in children.


A retrospective review of children sustaining penetrating pancreatic injuries was performed at eight pediatric trauma centers.


Sixteen patients were identified. Eleven patients were male; (mean ± SE) age was 11.7 ± 1.2 years. The mechanism of injury was gun-shot wound in 14 patients and mean injury-severity score was 18 ± 3. All patients had associated injuries, most frequently small bowel injuries (n = 9). Patients had either grade I (n = 4), grade II (n = 7), or grade III (n = 4) injuries; there was a single grade V injury. All patients underwent exploratory celiotomy. Drainage of the injured pancreas was performed in 11 patients, and 2 patients underwent pancreatorrhaphy in addition to drainage; 3 underwent resection for grade III (n = 2) and grade V (n = 1) injuries. Thirteen patients required other intra-abdominal procedures. All patients required intensive care over a mean 11.0 ± 3.0 days. Mean duration of stay was 30.1 ± 5.6 days. Post-operative morbidity was 62.5 % with no mortalities.


Penetrating pancreatic injuries in children are uncommon and most often due to firearms. There is a high association with other injuries particularly hollow viscous perforation.


Pediatric trauma Pancreatic trauma Penetrating trauma Children 


Conflict of interest

The authors declare they have no conflict of interest to disclose.


  1. 1.
    Arkovitz MS, Johnson N, Garcia VF (1997) Pancreatic trauma in children: mechanisms of injury. J Trauma 42:49–53PubMedCrossRefGoogle Scholar
  2. 2.
    Shilyansky J, Sena LM, Kreller M et al (1998) Nonoperative management of pancreatic injuries in children. J Pediatr Surg 33:343–349PubMedCrossRefGoogle Scholar
  3. 3.
    Keller MS, Stafford PW, Vane DW (1997) Conservative management of pancreatic trauma in children. J Trauma 42:1097–1100PubMedCrossRefGoogle Scholar
  4. 4.
    Stawicki SP, Schwab CW (2008) Pancreatic trauma: demographics, diagnosis, and management. Am Surg 74:1133–1145PubMedGoogle Scholar
  5. 5.
    Schroeppel TJ, Croce MA (2007) Diagnosis and management of blunt abdominal solid organ injury. Curr Opin Crit Care 13:399–404PubMedCrossRefGoogle Scholar
  6. 6.
    Vasquez JC, Coimbra R, Hoyt DB, Fortlage D (2001) Management of penetrating pancreatic trauma: an 11-year experience of a level-1 trauma center. Injury Int J Care Inj 32:753–759CrossRefGoogle Scholar
  7. 7.
    Young PR Jr, Meredith JW, Baker CC, Thomason MH, Chang MC (1998) Pancreatic injuries resulting from penetrating trauma: a multi-institution review. Am Surg 64:838–843PubMedGoogle Scholar
  8. 8.
    Ivatury RR, Nallathambi M, Rao P, Stahl WM (1990) Penetrating pancreatic injuries. Analysis of 103 consecutive cases. Am Surg 56:90–95PubMedGoogle Scholar
  9. 9.
    Sorensen VJ, Obeid FN, Horst HM, Bivins BA (1986) Penetrating pancreatic injuries, 1978–1983. Am Surg 52:354–358PubMedGoogle Scholar
  10. 10.
    Moore EE, Cogbill TH, Malangoni MA et al (1990) Organ injury scaling II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma 30:1427–1429PubMedCrossRefGoogle Scholar
  11. 11.
    Nadler EP, Gardner M, Schall LC, Lynch JM, Ford HR (1999) Management of blunt pancreatic injury in children. J Trauma 47:1098–1103PubMedCrossRefGoogle Scholar
  12. 12.
    Wales PW, Shuckett B, Kim PCW (2001) Long-term outcome after non-operative management of complete pancreatic transection in children. J Pediatr Surg 36:823–827PubMedCrossRefGoogle Scholar
  13. 13.
    Bass J, Di Lorenzo M, Desjardins JG et al (1988) Blunt pancreatic injuries in children: the role of percutaneous external drainage in the treatment of pancreatic pseudocysts. J Pediatr Surg 23:721–724PubMedCrossRefGoogle Scholar
  14. 14.
    Wood JH, Partrick DA, Bruny JL et al (2010) Operative vs nonoperative management of blunt pancreatic trauma in children. J Pediatr Surg 45:401–406PubMedCrossRefGoogle Scholar
  15. 15.
    Paul MD, Mooney DP (2011) The management of pancreatic injuries in children: operate or observe. J Pediatr Surg 46:1140–1143PubMedCrossRefGoogle Scholar
  16. 16.
    Iqbal CW, St. Peter SD, Tsao K et al (2014) Operative versus non-operative management for blunt pancreatic transection in children: multi-institutional outcomes. J Am Coll Surg 218:157–162PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hanna Alemayehu
    • 1
  • Kuojen Tsao
    • 2
  • Mark L. Wulkan
    • 3
  • Saleem Islam
    • 4
  • Robert T. Russell
    • 5
  • Todd A. Ponsky
    • 6
  • Daniel C. Cullinane
    • 7
  • Adam Alder
    • 8
  • Shawn D. St. Peter
    • 1
  • Corey W. Iqbal
    • 1
    Email author
  1. 1.Children’s Mercy Hospitals and ClinicsKansas CityUSA
  2. 2.University of Texas Health Science Center at Houston and Children’s Memorial Hermann HospitalHoustonUSA
  3. 3.Children’s Healthcare of Atlanta at EglestonAtlantaUSA
  4. 4.University of FloridaGainesvilleUSA
  5. 5.University of Alabama BirminghamBirminghamUSA
  6. 6.Akron Children’s HospitalAkronUSA
  7. 7.Marshfield ClinicMarshfieldUSA
  8. 8.Children’s Medical CenterDallasUSA

Personalised recommendations