Traumatic pancreatitis in children: a report of 13 cases

Objective: To investigate the clinical features,diagnosis and treatment of traumatic pancreatitis in children.Methods: The clinical data of 13 children with traumatic pancreatitis admitted from January 2003 to December 2011 were retrospectively analyzed.Results: The 13 patients,8 boys and 5 girls,were aged 5–12(7.22±3.54) years.The traumatic causes were due in 7 cases to abdominal contusion,in 4 cases to traffic-related accidents and in 2 cases to falls,and all of them were blunt abdominal injuries.Nine cases with class Ⅰ pancreatic injury(2 cases with concomitant liver contusion),and 3 cases with class Ⅱ pancreatic injury received conservative management such as intravenous antibiotics,fasting,gastrointestinal decompression,total parenteral nutrition,and pancreatic enzyme inhibition,and 4 of them developed a pancreatic pseudocyst at 1 month to 2 months a er discharge,of whom the lesion spontaneously resolved in 1 case a er symptomatic treatment,and 3 cases were treated by internal drainage by means of a Roux-Y cysto-jejunostomy(in one case laparoscopic anastomosis could not be done a er endoscopic exploration,and was converted to open surgery).One case with class Ⅲ pancreatic injury(accompanied with splenic contusion) underwent laparoscopic abdominal drainage,but developed a pancreatic pseudocyst 1 month later,and then underwent endoscopic exploration and Roux-Y cystojejunostomy.Eventually,all the patients were completely cured.Conclusion: e selection of treatment of traumatic pancreatitis in children should be based on the degree of pancreatic injury.Laparoscopic abdominal drainage is one of the e ective methods for traumatic pancreatitis in children with class Ⅲ injury,however,as well as laparoscopic Roux-Y cysto-jejunostomy,it requires further exploration and consideration.