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Failure of percutaneous drainage in children with traumatic pancreatic pseudocysts
F J Rescorla1, D Cory, D W Vane
1Department of Surgery, Indiana University Medical Center, Indianapolis.
Insights
Percutaneous drainage (PD) is a treatment for pediatric traumatic pancreatic pseudocysts. If PD fails, further investigation of pancreatic duct anatomy is crucial to identify major injuries.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Interventional Radiology
Background:
- Traumatic pancreatic pseudocysts can occur in children.
- Percutaneous drainage (PD) has emerged as a less invasive management option.
Abstract:
Recent reports have documented the successful use of percutaneous drainage (PD) in the management of traumatic pancreatic pseudocysts in children. This study presents four cases of pancreatic pseudocyst in which percutaneous catheter drainage was performed. In one instance, no operative therapy was required. However, in the other three cases PD failed to resolve the problem and distal pancreatectomy with splenic salvage was performed when contrast studies (endoscopic retrograde cholangiopancreatography or catheter injection) demonstrated disruption of the main pancreatic duct. This report suggests that children with pancreatic pseudocysts unresponsive to PD require prompt investigation of ductal anatomy to rule out transection or other major injury.