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Blunt pancreatic trauma in children

Surgery Today volume 41, pages 946–954 (2011)Cite this article

Abstract

Purpose

To report our experience with blunt pancreatic trauma in pediatric patients and evaluate several various management strategies.

Methods

Ten children admitted over the last 10 years with pancreatic blunt trauma were included in the present series.

Results

The average time from injury to hospital admission was 2.4 days. All injuries resulted from accidents: bicycle handlebar injuries (5), being kicked by a horse (2), falls from a height (2), and injury sustained during closure of an electric gate (1). Additional systemic and abdominal injuries were recorded in 7 patients. The amylase levels at the time of patient admission were normal in 3 patients, mildly raised in 4 patients, and elevated in 3 patients. Abdominal computed tomography was performed in 10 patients, ultrasonography in 5, and endoscopic retrograde cholangiopancreatography (ERCP) in 4. Pancreatic injuries comprised 4 grade I, 3 grade II, and 3 grade III injuries. Grade I and II injuries were successfully managed by conservative treatment. The 3 children with grade III trauma and pancreatic ductal injury in the neck (1), body (1), and tail (1) of the gland were surgically treated, having an uneventful postoperative stay of 8–14 days and no complications during the 1-year follow-up period.

Conclusion

The present study supports early ERCP as an essential part of the initial patient evaluation when pancreatic transection is highly suspected.

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Author information

Affiliations

  1. Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Baruch Klin, Yigal Efrati & Gad Lotan

  2. Pediatric Intensive Care Unit, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Ibrahim Abu-Kishk & Gideon Eshel

  3. Trauma Unit, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Igor Jeroukhimov

  4. Pediatric Emergency Department, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Eran Kozer

  5. Pediatric Gastroenterology Unit, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Efrat Broide, Yuri Brachman & Eitan Scapa

  6. Department of Diagnostic Imaging, Assaf Harofeh Medical Center, Zerifin, 70300, Israel

    Laurian Copel

  7. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Laurian Copel

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  1. Baruch Klin
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  2. Ibrahim Abu-Kishk
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  10. Gideon Eshel
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Klin, B., Abu-Kishk, I., Jeroukhimov, I. et al. Blunt pancreatic trauma in children. Surg Today 41, 946–954 (2011). https://doi.org/10.1007/s00595-010-4369-y

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Key words

  • Pancreas
  • Pediatric
  • Trauma
  • Gastrointestinal