title: Multi-institutional experience with penetrating pancreatic injuries in children.
abstract: OBJECTIVE
  Penetrating pancreatic injuries in children are uncommon and are not well described in the literature. We report a multi-institutional experience with penetrating pancreatic injuries in children.
  
  
  METHODS
  A retrospective review of children sustaining penetrating pancreatic injuries was performed at eight pediatric trauma centers.
  
  
  RESULTS
  Sixteen patients were identified. Eleven patients were male; (mean ± SE) age was 11.7 ± 1.2 years. The mechanism of injury was gun-shot wound in 14 patients and mean injury-severity score was 18 ± 3. All patients had associated injuries, most frequently small bowel injuries (n = 9). Patients had either grade I (n = 4), grade II (n = 7), or grade III (n = 4) injuries; there was a single grade V injury. All patients underwent exploratory celiotomy. Drainage of the injured pancreas was performed in 11 patients, and 2 patients underwent pancreatorrhaphy in addition to drainage; 3 underwent resection for grade III (n = 2) and grade V (n = 1) injuries. Thirteen patients required other intra-abdominal procedures. All patients required intensive care over a mean 11.0 ± 3.0 days. Mean duration of stay was 30.1 ± 5.6 days. Post-operative morbidity was 62.5% with no mortalities.
  
  
  CONCLUSIONS
  Penetrating pancreatic injuries in children are uncommon and most often due to firearms. There is a high association with other injuries particularly hollow viscous perforation.
authors.affiliation: Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA.
authors.forename: Hanna
authors.initials: H
authors.lastname: Alemayehu
authors.forename: Kuojen
authors.initials: K
authors.lastname: Tsao
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wulkan
authors.forename: Saleem
authors.initials: S
authors.lastname: Islam
authors.forename: Robert T
authors.initials: RT
authors.lastname: Russell
authors.forename: Todd A
authors.initials: TA
authors.lastname: Ponsky
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cullinane
authors.forename: Adam
authors.initials: A
authors.lastname: Alder
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.forename: Corey W
authors.initials: CW
authors.lastname: Iqbal
mesh_terms: D002648:Child; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007421:Intestine, Small / Q000293:injuries; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D014193:Trauma Centers / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000453:epidemiology*