title: Pancreatic injury in children: review of 7 cases and the pertinent literature.
abstract: OBJECTIVE
  Treatment of blunt injury of the pancreas in children remains controversial. Some prefer non-surgical treatment, whereas others prefer surgical management in selected cases. This report reviews our management strategies of children with blunt pancreatic trauma and their outcomes.
  
  
  METHODS
  Medical records of 7 children with traumatic pancreatic injury were retrospectively analyzed in our institutions. In addition, we reviewed the pertinent literature.
  
  
  RESULTS
  There were 2 males and 5 females with a median age of 7.6 years. Pancreatic injury was classified in 3 patients as grade I, in 2 patients as grade II, and in 2 patients as grade III (AAST). The two grade III children underwent ERCP preoperatively. ERCP showed injury to the main pancreatic duct in both of these patients, and emergency surgery was performed for both of them. These operative methods were spleen-preserving distal pancreatectomy and only drainage at the margin of the pancreas with non-resection, respectively. All 7 cases survived.
  
  
  CONCLUSIONS
  ERCP is helpful for the diagnosis of suspected cases in pancreatic injury with grade III. In hemorrhagic shock state, appropriate surgical procedures with only drainage at the margin of the pancreas are useful for the treatment of pancreatic fistula in children.
authors.affiliation: Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan. 3949noex@jcom.home.ne.jp
authors.forename: Ippei
authors.initials: I
authors.lastname: Yamana
authors.forename: Shunji
authors.initials: S
authors.lastname: Kawamoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Kamitani
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ishikura
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000681:Amylases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007564:Japan; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging / Q000201:enzymology / Q000293:injuries* / Q000601:surgery*; D010180:Pancreatectomy; D010185:Pancreatic Fistula / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000097:blood / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*
chemical_list: D015415:Biomarkers; D000681:Amylases