title: Role of ERCP in pediatric blunt abdominal trauma: a case series at a level one pediatric trauma center.
abstract: BACKGROUND
  There is no consensus regarding the appropriate use of endoscopic retrograde cholangiopancreatography (ERCP) in pediatric trauma. We report our experience with ERCP for management of pediatric pancreatic and biliary injury following blunt abdominal trauma.
  
  
  METHODS
  A retrospective chart review was performed for pediatric patients with blunt abdominal trauma from July 2008 through December 2012 at our pediatric trauma center. For patients who underwent ERCP, demographics, injury characteristics, diagnostic details, procedures performed, length of stay, total parenteral nutrition use, and complications were reviewed.
  
  
  RESULTS
  There were 532 patients identified: 115 hepatic injuries, 25 pancreatic injuries and one gall bladder injury. Nine patients (mean age 7.8 years) underwent ERCP. Seven (78%) had pancreatic injuries, while two (22%) had bilateral hepatic duct injuries. The median time to diagnosis was one day (range, 0-12). Diagnostic ERCP only was performed in three patients, two of which proceeded to distal pancreatectomy. Five patients had stents placed (two biliary and three pancreatic) and four sphincterotomies were performed. Despite pancreatic stenting, one patient required distal pancreatectomy for persistent leak. Median length of stay was 11 days.
  
  
  CONCLUSIONS
  Pediatric pancreatic and biliary ductal injuries following blunt abdominal trauma are uncommon. ERCP can safely provide definitive treatment for some patients.
authors: Division of General Surgery, The Mayo Clinic, 5777 E Mayo Blvd. Phoenix, AZ 85255 USA.
authors: Erin M
authors: EM
authors: Garvey
authors: Division of General Surgery, The Mayo Clinic, 5777 E Mayo Blvd. Phoenix, AZ 85255 USA.
authors: Danielle J
authors: DJ
authors: Haakinson
authors: Pediatric Gastroenterology, Phoenix Children's Hospital, 1920 E Cambridge Ave. Phoenix, AZ 85006 USA.
authors: Mark
authors: M
authors: McOmber
authors: Division of General Surgery, The Mayo Clinic, 5777 E Mayo Blvd. Phoenix, AZ 85255 USA; Pediatric Surgery, Phoenix Children's Hospital, 1920 E Cambridge Ave. Phoenix, AZ 85006 USA. Electronic address: DNotrica@surgery4children.com.
authors: David M
authors: DM
authors: Notrica
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008099:Liver / Q000293:injuries / Q000601:surgery*; D008297:Male; D010179:Pancreas / Q000293:injuries* / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*
keywords: Biliary injury; Blunt abdominal trauma; Duct stenting; Endoscopic retrograde cholangiopancreatography; Pancreatic injury; Pediatric