Blunt pancreatic injuries in children: The role of percutaneous external drainage in the treatment of pancreatic pseudocysts

• Published in: Journal of pediatric surgery Vol. 23; no. 8; pp. 721 - 724
• Main Authors: Bass, Juan, Lorenzo, Maria Di, Desjardins, Jean G., Grignon, Andrée, Ouimet, Alain
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.1988
• Subjects: Adolescent; Blunt pancreatic trauma in childhood; Child; Child, Preschool; Drainage - methods; Female; Humans; Male; Pancreas - injuries; Pancreatic Cyst - surgery; Pancreatic Pseudocyst - diagnosis; Pancreatic Pseudocyst - diagnostic imaging; Pancreatic Pseudocyst - etiology; Pancreatic Pseudocyst - surgery; percutaneous pseudocyst drainage; Radiography; Ultrasonography; Wounds, Nonpenetrating - complications; Blunt pancreatic trauma in childhood; percutaneous pseudocyst drainage
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/S0022-3468(88)80410-X

During the past 10 years, 26 cases of blunt pancreatic trauma were diagnosed in our institution. In 42.3% (11/26) the accident was bicycle-related. Seventy-three percent of patients were seen within 48 hours of injury. The most frequent clinical presentations included abdominal pain, tenderness and vomiting. Diagnosis of pancreatic injury was suggested by hyperamylasemia in most cases. Associated trauma was seen in seven patients (26.9%) and it was intraabdominal in four (15.3%). Computerized tomography (CT) scan is the single most useful radiologic investigation in evaluating pancreatic trauma. Ultrasound, although less accurate than CT scan in determining the severity of the initial injury, is useful in the evaluation and treatment of pancreatic pseudocysts. Pancreatic pseudocysts developed in ten patients. Spontaneous resolution occurred in five (50%). In three patients, percutaneous external drainage (PED) was successful in treating pancreatic pseudocysts without complications or recurrence at 11, 19, and 31 months. PED is a suitable form of treatment in selected cases of pancreatic pseudocysts. Results in children are better than in the adult population, probably due to the absence of primary pancreatic pathology. We believe that PED should be considered the primary therapeutic procedure for traumatic pancreatic collections prior to more invasive surgical treatment, when there is no evidence of pancreatic duct transection on CT scan.