title: Blunt pancreatic trauma in children.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  The present study supports early ERCP as an essential part of the initial patient evaluation when pancreatic transection is highly suspected.
authors: Department of Pediatric Surgery, Assaf Harofeh Medical Center, Zerifin, 70300, Israel.
authors: Baruch
authors: B
authors: Klin
authors: Ibrahim
authors: I
authors: Abu-Kishk
authors: Igor
authors: I
authors: Jeroukhimov
authors: Yigal
authors: Y
authors: Efrati
authors: Eran
authors: E
authors: Kozer
authors: Efrat
authors: E
authors: Broide
authors: Yuri
authors: Y
authors: Brachman
authors: Laurian
authors: L
authors: Copel
authors: Eitan
authors: E
authors: Scapa
authors: Gideon
authors: G
authors: Eshel
authors: Gad
authors: G
authors: Lotan
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D010179:Pancreas / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery