[Pancreatic injury in abdominal trauma in children: difficult to diagnose and treat].

Pancreatic injury in children is rare. The diagnosis is difficult to establish because shortly after an accident there is frequent lack of complaints and the blood test often still normal. Also, additional investigations in the initial stage are often very specific. The treatment of pancreatic lesions without involvement of the pancreatic duct (grades 1 and 2) is conservative. With regards to lesions involving the pancreatic duct (grade 3 and above) there also seems to be a shift to non-surgical treatment, but there is still little evidence for either treatment modality. Based on three children’s cases, two with grade 3 and one with a grade 2 pancreatic lesions, we provide insight in the difficulty in diagnosis and treatment. A high “index of suspicion”, reassess after six hours, and accessible consultation or referral to a trauma center, is frequently recommended regarding these injuries. Pancreatic injury in abdominal trauma in children: difficult to diagnose and treat 101