Treatment of pancreatic duct disruption in children by an endoscopically placed stent☆
Section snippets
Case 1
A 9-year-old girl was referred to the emergency room several hours after falling off her bike, striking her left midabdomen on the handlebars. Over the next few hours she had increasing abdominal pain and vomiting. Findings were limited to a bruise and tenderness in the left epigastrium. The initial serum amylase level was 436 IU (normal, <125 IU). CT scan on admission suggested a partial disruption of pancreatic parenchyma at the midbody (Fig 1A).
Discussion
The pancreas is the fourth most commonly injured intraabdominal solid organ in children as a result of blunt abdominal trauma.3, 18 Improvements in imaging by CT scan have suggested that the severity of pancreatic injury could be determined accurately and dictate appropriate operative or nonoperative therapy. In a recent review of data from our institution and others, we advocated conservative management of class I minor injuries, spleen-sparing distal pancreatectomy for class II distal ductal
References (24)
- et al.
Characteristics of pancreatic injury in children: A comparison with such injury in adults
J Pediatr Surg
(1996) - et al.
Management of pancreatic injury in pediatric blunt abdominal trauma
J Pediatr Surg
(1999) - et al.
The efficacy of early ERCP in pediatric pancreatic trauma
J Pediatr Surg
(1995) - et al.
Nonoperative management of pancreatic injuries in children
J Pediatr Surg
(1998) - et al.
The case for preoperative and intraoperative ERCP in pancreatic trauma
Gastrointest Endosc
(1988) - et al.
Endoscopic intrapancreatic stent for traumatic duct injury
Injury
(1995) - et al.
Pancreatic trauma in children: Mechanisms of injury
J Trauma
(1997) - et al.
Computed tomography: An unreliable indicator of pancreatic trauma
Am Surg
(1996) - et al.
Demonstration of pancreatic ductal integrity by endoscopic retrograde pancreatography allows conservatic surgical management
J Trauma
(1996) - et al.
Urgent endoscopic retrograde pancreatography in the stable trauma patient
Am Surg
(1996)
Distal pancreatectomy for trauma: A multicenter experience
J Trauma
Endoscopic retrograde cholangiopancreatography and endobiliary stenting for the treatment of a bile leak in a child
J Pediatr Gastroenterol Nutr
Cited by (0)
- ☆
Address reprint requests to Timothy G. Canty Sr, MD, 3030 Children's Way, Suite 401, San Diego, CA 92123.