BAPS paperPediatric pancreatic trauma: predictors of nonoperative management failure and associated outcomes
Section snippets
Methods
A multiinstitutional retrospective case review was conducted from January 1993 to December 2002 of all patients with blunt pancreatic injuries from the trauma registries of 7 designated level I pediatric trauma centers. (Table 1) Failure of nonoperative management was defined as the need for an intraabdominal operative intervention. Injuries were graded I to V according to Organ Injury Scaling of the American Association for the Surgery of Trauma. Ductal Injuries were defined as grades III to V.
Results
There were 1823 patients identified with blunt abdominal trauma, 173 with injury to the pancreas (9.5%). Forty-three patients with pancreatic injury required operative intervention (26.0%). Ductal injuries were present in 53, with 23 requiring an operation (43.4%). The mean age of patients treated nonoperatively was 7.84 years (range, 1 month to 17 years) and was 7.56 years (range, 1-17 years) in patients requiring an operation. Boys accounted for 63.3% of operative patients and 62.2% of those
Discussion
Current standard of care for injury to solid organs after blunt trauma is NOM. The optimal management of injury to the pancreas has been more controversial. A small number of studies in both the adult and pediatric literature have assessed the use of ERCP in patients with pancreatic injury [5], [6]. Several other studies have analyzed the treatment of pancreatic injuries, but few have compared operative treatment to NOM [1], [2], [3], [4], [5], [6], [7], [8]. The data in this study were
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Endoscopy and Pediatric Pancreatitis
2023, Gastrointestinal Endoscopy Clinics of North AmericaOperative versus non-operative management of blunt pancreatic trauma in children: Systematic review and meta-analysis
2021, InjuryCitation Excerpt :Furthermore, pancreatic trauma is often associated with other abdominal injuries, such as duodenal injuries, that have pronounced clinical picture that may mask pancreatic injury. Increased amylase and lipase levels may be helpful, and are often elevated in pancreatic trauma, although they may be normal in the first few hours after the trauma, and it may take several serial investigations to demonstrate and increase in serum amylase or lipase levels [3,16,43]. Increase serum amylase levels are also not specific to pancreatic trauma and may be elevated in cases of head and neck trauma that is often associated with pancreatic trauma).
Parenteral nutrition prolongs hospital stay in children with nonoperative blunt pancreatic injury: A propensity score weighted analysis
2020, Journal of Pediatric SurgeryA non-operative strategy for grade IV blunt pancreatic trauma
2019, Journal of Pediatric Surgery Case ReportsEarly local drug therapy for pancreatic contusion and laceration
2019, Pancreatology
Presented as an oral presentation at the British Association of Paediatric Surgeons Conference in Stockholm, Sweden, July 18-21, 2006.