Management of traumatic complete pancreatic fracture in a child: case report and review of literature.
Blunt abdominal trauma is the most common cause of pancreatic injury in children. Laparoscopic distal pancreatectomy in a child with complete duct disruption has not been reported in the literature in children, although it has been well described in adults.


METHODS
In this paper report a case of a 7-year-old male, with grade 4 pancreatic trauma, who was treated nonoperatively in the acute phase and subsequently by laparoscopic distal pancreatectomy 3 months after the trauma.


CONCLUSIONS
Although in adults the surgical management of grade 3-4 pancreatic traumatic injury is well described, including the laparoscopic approach, no report of laparoscopic distal pancreatectomy was found in the literature. We would like to emphasize the importance of using a conservative management in the acute phase of pancreatic injury, including grade 4 injuries. After this phase, the use of the high-definition computed tomography scan and endoscopic retrograde pancreatography were fundamental.


CONCLUSIONS
Magnification of laparoscopic technique allowed us to identify the structures much better than open surgery.
Leva
Ernesto
E
Department of Pediatric Surgery, V Buzzi Children's Hospital of Milan, Milan, Italy. ernleva@tin.it
Huscher
Cristiano
C
Rode
Heinz
H
Fava
Giorgio
G
Napolitano
Marcello
M
Maestri
Luciano
L
Pansini
Andrea
A
Cocozza
Eugenio
E
Numanoglu
Alp
A
Prada
Alberto
A
Sortino
Giorgia
G
Pansini
Luigi
L
D000007:Abdominal Injuries / Q000209:etiology / Q000473:pathology*; D001642:Bicycling / Q000293:injuries; D002648:Child; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000473:pathology; D010180:Pancreatectomy; D010183:Pancreatic Ducts / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000473:pathology