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Percutaneous drainage of traumatic pancreatic pseudocysts in children
R B Jaffe1, J A Arata, M E Matlak
1Department of Radiology, Primary Children's Medical Center, Salt Lake City, UT 84103.
Insights
Percutaneous catheter drainage offers a safe and effective treatment for children with traumatic pancreatic pseudocysts. This minimally invasive approach avoids surgery, leading to successful outcomes and symptom resolution in most young patients.
Area of Science:
- Pediatric Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Traditionally, surgical intervention was the standard for pediatric pancreatic pseudocysts.
- Traumatic pancreatic pseudocysts in children present unique management challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of percutaneous catheter drainage for posttraumatic pancreatic pseudocysts in children.
- To compare percutaneous drainage with historical surgical management.
Main Methods:
- Seven pediatric patients (3-13 years) with traumatic pancreatic pseudocysts underwent percutaneous catheter drainage.
- Procedures utilized local anesthesia and sedation under sonographic or CT guidance.
- Drainage was achieved via transgastric or direct transcutaneous approaches.
Main Results:
- All procedures were technically successful with no serious complications.
- Six patients achieved complete resolution of pseudocysts and normalization of serum amylase.
- One patient experienced catheter dislodgement but ultimately resolved residual pseudocyst.
Conclusions:
- Percutaneous catheter drainage is a safe and effective alternative to surgery for pediatric traumatic pancreatic pseudocysts.
- This minimally invasive technique facilitates rapid recovery and symptom relief.
- Further research can explore long-term outcomes and optimal drainage durations.
Abstract:
In the past, children with pancreatic pseudocysts have been managed surgically. We report seven children 3-13 years old with posttraumatic pancreatic pseudocysts who were managed with percutaneous catheter drainage. All procedures were performed with local anesthesia and intramuscular sedation under sonographic or CT guidance. Two of the pseudocysts were drained via a transgastric approach, the other five via direct transcutaneous access to the pseudocyst. The catheters were in place an average of 25 days (range, 8-66). There were no serious complications. Six patients became asymptomatic with return of the serum amylase to normal and resolution of the pseudocyst on follow-up sonograms. One patient, in whom the catheter became dislodged after 2 weeks, became asymptomatic, but he had a residual 2-cm pancreatic pseudocyst that resolved over the next 6 weeks. Our experience suggests that percutaneous drainage is a safe and effective method of treatment for traumatic pancreatic pseudocysts in children.