Predicting pseudocyst formation following pancreatic trauma in pediatric patients
- 385 Downloads
There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma.
Materials and methods
The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3–5 were enrolled. The patients were divided into groups that developed [Group 1 (n = 20)] and did not develop [Group 2 (n = 18)] PC. The patients were evaluated in terms of their baseline characteristics, additional injuries, Injury Severity Score (ISS), pancreatic injury site, blood amylase levels 2 h and 10–15 days after the trauma, clinical presentation, and duration of intensive care unit (ICU) stay.
We followed 38 patients. Of the patients in Group 1, 70 % had an injury to the tail of the pancreas. The ISS trauma scores and durations of hospitalization and ICU stay were significantly greater in Group 2 (p < 0.05). The mean blood amylase level on Day 1 was 607 U/L (range 183–801 U/L) in Group 1 and 314 U/L (range 25–631 U/L) in Group 2; the respective levels on Day 10 were 838 U/L (range 123–2951 U/L) and 83.2 U/L (range 35–164 U/L). The serum amylase levels were significantly higher (p < 0.001) in Group 1 than in Group 2 on Days 1 and 10. Four patients developed complications and two patients died.
Pancreatic pseudocyst formation is more likely in patients with AAST Grade 3 pancreatic injury, also serum amylase levels ten times greater than normal 2 h after the trauma, and persistently elevated serum amylase levels 10–15 days following the trauma.
KeywordsPredict Pseudocyst Pancreatic trauma Pediatric trauma
Compliance with ethical standards
Conflicts of interest
The authors declare that they have no conflicts of interest.
The authors have indicated they have no financial relationships relevant to this article to disclosure.
- 3.Steven Stylianos, RH Pearl (2012) Abdominal trauma. Pediatric surgery. In: Arnold G Coran MD, N. Scott Adzick MD, Thomas M. Krummel MD, Jean-Martin Laberge, Robert Shamberger, Anthony Caldamone MD (eds) Pediatric surgery, 7th edn. Elsevier, Philadelphia, pp 289–309Google Scholar