Pancreatic injury in children: A case report and review of the literature

被引：11

作者：

Haider F. ^{[1
]}

Al Awadhi M.A. ^{[1
]}

Abrar E. ^{[1
]}

Al Dossari M. ^{[1
]}

Isa H. ^{[2
]}

Nasser H. ^{[3
]}

Al Hashimi H. ^{[3
]}

Al Arayedh S. ^{[3
]}

机构：

[1] Pediatric Surgery Unit, Department of Surgery, Salmaniya Medical Complex, P.O. Box 12, Manama

[2] Department of Pediatrics, Salmaniya Medical Complex, Manama

[3] Department of Radiology, Salmaniya Medical Complex, Manama

来源：

Journal of Medical Case Reports | / 11卷 / 1期

关键词：

Blunt trauma abdomen; Case report; Computed tomography; Liver injury; Non-operative management; Pancreatic injury; Pancreatic pseudocyst; Total parenteral nutrition;

D O I：

10.1186/s13256-017-1383-3

中图分类号：

学科分类号：

摘要：

Background: Trauma is the main cause of morbidity and mortality in the pediatric population. Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury, although uncommon (2 to 9%), is the fourth most common solid organ injury. Unlike other solid organ injuries, pancreatic trauma may be subtle and difficult to diagnose. Computed tomography currently is the imaging modality of choice. As the incidence of pancreatic injury in children sustaining blunt abdominal trauma is low, management remains a challenge. Case presentation: We present a 7-year-old Bahraini boy who sustained blunt trauma to his abdomen. He presented with abdominal pain and vomiting. His examination revealed abdominal distension and an epigastric bruise. Contrast-enhanced computed tomography reported grade III liver injury, grade I bilateral renal injury, a suspicion of splenic injury, and a grade III to IV pancreatic injury. He was admitted to Pediatric Intensive Care Unit and was treated conservatively. Because he was stable, he was discharged to the surgical ward at day 3. At day 18 he developed a pancreatic pseudocyst that was aspirated and recurred at day 25 when a pigtail catheter was inserted. He was kept on total parenteral nutrition through a peripherally inserted central catheter. The pigtail catheter was removed on day 36 and a low fat diet was started by day 44. He was discharged home at day 55 in good health. Out-patient follow-up and serial abdominal ultrasound showed resolution of the cyst and normalization of blood tests. Conclusion: Non-operative management of pancreatic injury is effective and safe in hemodynamically stable patients with no other indication for surgery. © 2017 The Author(s).

引用

共 10 条

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