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[How I explore and treat...A pancreatic trauma in a child]
Insights
A ten-year-old boy sustained a pancreatic fracture from a bicycle handlebar injury. Initial non-invasive management led to a pseudocyst, successfully treated with endoscopic drainage.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Trauma Management
Background:
- Blunt abdominal trauma can cause pancreatic injury.
- Handlebar injuries are a known mechanism for pediatric pancreatic trauma.
- Early diagnosis and monitoring are crucial for managing pancreatic injuries.
Observation:
- A ten-year-old boy experienced a pancreatic fracture after a bicycle fall.
- Imaging (ultrasound and CT) confirmed pancreatic rupture.
- Initial non-invasive management was followed by pseudocyst formation.
Findings:
- The pancreatic pseudocyst was successfully treated with transgastric endoscopic echo-guided drainage.
- This case highlights a delayed complication of pancreatic trauma.
- Effective management involved monitoring and subsequent minimally invasive intervention.
Implications:
- Guidelines for pancreatic trauma management should consider delayed complications like pseudocysts.
- Endoscopic ultrasound-guided drainage offers a successful minimally invasive option for pancreatic pseudocysts.
- This case underscores the importance of vigilant follow-up in pediatric pancreatic injuries.
Abstract:
We report the case of a pancreatic fracture following a bicycle fall and handlebar injury in a ten years old boy. Pancreatic rupture was detected by abdominal ultrasonography and computed tomography. The child was closely monitored, without undertaking any initial invasive treatment, but the clinical course was complicated by the emergence of a pancreatic pseudocyst. After weeks of monitoring, a transgastric endoscopic echo-guided drainage was performed with success. We present in this paper the guidelines concerning the management of a pancreatic trauma and discuss the indications and drainage methods for pseudocysts.