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Percutaneous drainage of traumatic pancreatic pseudocysts in children
C Burnweit1, D Wesson, D Stringer
1Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
Percutaneous drainage is an effective treatment for traumatic pancreatic pseudocysts in children. This minimally invasive approach offers a safe alternative to surgery, avoiding complications and recurrence.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Traumatic pancreatic pseudocysts are a significant complication in children.
- Standard operative therapy, such as pseudocystenteric anastomosis, carries risks.
- Minimally invasive techniques are being explored for pediatric surgical conditions.
Purpose of the Study:
- To evaluate the efficacy of percutaneous drainage for traumatic pancreatic pseudocysts in pediatric patients.
- To compare percutaneous drainage with traditional surgical interventions.
- To assess the safety and recurrence rates of percutaneous drainage.
Main Methods:
- Retrospective review of 13 children with traumatic pancreatic pseudocysts.
- Five children underwent percutaneous drainage with fluoroscopic guidance.
- Cyst fluid analysis (amylase levels, culture) and ultrasound follow-up were performed.
Main Results:
- Percutaneous drainage successfully treated five pseudocysts (5-15 cm diameter, 10-42 days duration).
- Cyst fluid was clear, with high amylase levels (>40,000 IU/L) and no bacterial growth.
- No complications or pseudocyst recurrence were observed during follow-up.
Conclusions:
- Percutaneous drainage is a safe and effective alternative to surgery for pediatric traumatic pancreatic pseudocysts.
- This minimally invasive method avoids the complications associated with operative procedures.
- Ultrasound monitoring ensures successful resolution and long-term outcomes.
Abstract:
To determine the effectiveness of percutaneous drainage of traumatic pancreatic pseudocysts, we reviewed the courses of 13 children. Six pseudocysts resolved on complete bowel rest and total parenteral nutrition. Seven required further therapy. Two pseudocysts were treated operatively; five were drained percutaneously with fluoroscopic guidance. These five ranged from 5 to 15 cm in diameter and were present for 10 to 42 days (mean, 26 days). In all cases, the cyst fluid was clear, had an amylase level of greater than 40,000 IU/L, and grew no organisms. The pigtail catheters left in place in four of the five children were removed when drainage stopped. Patients were followed by ultrasound while still in the hospital and 1 month after discharge. There were no complications nor any pseudocyst recurrence. Percutaneous drainage of traumatic pancreatic pseudocysts in children is an effective alternative to the standard operative therapy of pseudocystenteric anastomosis.