Pancreatic trauma in children.
BACKGROUND
Pancreatic trauma is rare in children, and management strategies are diverse and controversial. The aim of this study was to report the outcome of a consecutive series of children with pancreatic injury seen at a single regional centre over a decade.


METHODS
All children under 14 years of age referred with pancreatic injury between January 1995 and June 2004 were reviewed retrospectively.


RESULTS
Nine children (six boys) aged 3-13 years sustained pancreatic injuries: one grade I (minor contusion), two grade II (major contusion without duct injury or tissue loss), five grade III (distal transection and duct injury) and one grade IV (proximal transection). Grade I and II injuries were successfully managed without surgery. The five children with grade III injuries were initially treated without operation, but each developed a large symptomatic pseudocyst that failed to resolve with percutaneous drainage. Four underwent a spleen-sparing distal pancreatectomy and one boy with a transected pancreatic neck was treated by Roux-en-Y jejunostomy drainage. A 6-year-old boy who sustained severe pancreatobiliary trauma (grade IV) was treated by Roux-en-Y drainage. All children made a full recovery.


CONCLUSIONS
The management of pancreatic injuries in children should be individualized depending on the site of injury, timing of referral, presence of associated injuries and institutional expertise.
Stringer
M D
MD
Children's Liver and Gastrointestinal Unit, St James's University Hospital, Leeds LS9 7TF, UK. mdstringer@dial.pipex.com
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods