Traumatic pancreatic injury after blunt abdominal trauma among children

Abstract

Traumatic pancreatic injuries or traumatic pancreatitis are rare among children and difficult to diagnose because of the nonspecific symptoms. A review of the literature from the last 20 years on the diagnostic approaches and management of blunt pancreatic injury in children was performed and practical guidelines are proposed.

A high index of suspicion for pancreatic injuries is needed for all pediatric patients with blunt abdominal injuries. Diagnosis is made based on a combination of laboratory findings and radiological imaging (ultrasound, or more preferably in the acute setting, computed tomography of the abdomen). Early surgical treatment may benefit patients with main pancreatic duct injuries, while other types of pancreatic injuries can be treated non-operatively. Although, randomized controlled trials are lacking to justify the most appropriated approach. The most common short-term complication after pancreatic injury is the development of pseudocysts and can be treated conservatively if asymptomatic. The risk of development of diabetes mellitus or exocrine pancreatic insufficiency as long-term complication in children remains unknown. More prospective trials and research initiatives are required.