Pancreatic injuries in children.
OBJECTIVE
There are several different philosophies in the diagnostics of blunt abdominal trauma (BAT), yet none of them has been shown to be superior, although enhanced computed tomography (CT) and diagnostic ultrasonography (US) seem to be the most used methods today. Treatment of pancreatic injury (PI) in children is a matter of controversy, whether operative treatment is needed and to what extent.


METHODS
Seventeen pancreatic injuries were found in a retrospective analysis of 111 paediatric patients, aged 2-14 years, who underwent a laparotomy because of BAT, between 1968 and 1995 in Turku University Central Hospital. The number of non-operated BAT patients was calculated as 287.


RESULTS
During the past two decades, the number of BATs and operations diminished by more than two thirds, but the number of PIs remained the same. Twelve acute operations led to four pancreatic resections, two external drainages and two explorations. PI was present but not the main reason for operation in four cases. Five PIs were operated on later due to postraumatic pseudocyst of the pancreas.


CONCLUSIONS
PI was rare (15%) in laparotomies done because of BAT, operations which have diminished by 74% during the last twenty years. When PI was found, a variety of operative procedures was needed.
Alanen
M
M
Department of Paediatric Surgery, Turku University Central Hospital, Finland. markku.alanen@tyks.fi
Pajulo
O
O
Reunanen
M
M
D000007:Abdominal Injuries / Q000175:diagnosis*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000293:injuries*; D012189:Retrospective Studies; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*