title: Predicting pseudocyst formation following pancreatic trauma in pediatric patients.
abstract: BACKGROUND
  There are insufficient data on pre-screening for pancreatic pseudocysts (PC) following pancreatic trauma. This study investigated the use of radiological and laboratory testing for predicting the development of pancreatic pseudocysts after trauma.
  
  
  METHODS
  The clinical records of all pediatric patients presenting with pancreatic trauma between January 2003 and December 2014 were reviewed retrospectively. Patients with American Association for the Surgery of Trauma (AAST) scores of Grade 3-5 were enrolled. The patients were divided into groups that developed [Group 1 (n = 20)] and did not develop [Group 2 (n = 18)] PC. The patients were evaluated in terms of their baseline characteristics, additional injuries, Injury Severity Score (ISS), pancreatic injury site, blood amylase levels 2 h and 10-15 days after the trauma, clinical presentation, and duration of intensive care unit (ICU) stay.
  
  
  RESULTS
  We followed 38 patients. Of the patients in Group 1, 70 % had an injury to the tail of the pancreas. The ISS trauma scores and durations of hospitalization and ICU stay were significantly greater in Group 2 (p < 0.05). The mean blood amylase level on Day 1 was 607 U/L (range 183-801 U/L) in Group 1 and 314 U/L (range 25-631 U/L) in Group 2; the respective levels on Day 10 were 838 U/L (range 123-2951 U/L) and 83.2 U/L (range 35-164 U/L). The serum amylase levels were significantly higher (p < 0.001) in Group 1 than in Group 2 on Days 1 and 10. Four patients developed complications and two patients died.
  
  
  CONCLUSIONS
  Pancreatic pseudocyst formation is more likely in patients with AAST Grade 3 pancreatic injury, also serum amylase levels ten times greater than normal 2 h after the trauma, and persistently elevated serum amylase levels 10-15 days following the trauma.
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey. bahattinaydogdu@hotmail.com.
authors: Bahattin
authors: B
authors: Aydogdu
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Serkan
authors: S
authors: Arslan
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Hikmet
authors: H
authors: Zeytun
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Mehmet Serif
authors: MS
authors: Arslan
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Erol
authors: E
authors: Basuguy
authors: Department of Trauma and Emergency, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Mustafa
authors: M
authors: İçer
authors: Department of Radiology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Cemil
authors: C
authors: Goya
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Mehmet Hanifi
authors: MH
authors: Okur
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Ibrahim
authors: I
authors: Uygun
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Murat Kemal
authors: MK
authors: Cıgdem
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Abdurrahman
authors: A
authors: Onen
authors: Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280, Diyarbakir, Turkey.
authors: Selcuk
authors: S
authors: Otcu
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000175:diagnosis; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010179:Pancreas / Q000601:surgery; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis
keywords: Pancreatic trauma; Pediatric trauma; Predict; Pseudocyst