Duct-related complications of pediatric post-traumatic pancreatitis: A case report from Syria

Pancreatic trauma is a rare type of abdominal injury, representing only 0.3 % of pediatric trauma cases. This condition may progress to chronic pancreatitis and result in multiple complications following damage to the pancreatic duct.

A 5-year-old boy presented to the hospital with abdominal pain and had a history of chronic pancreatitis following a bicycle handlebar accident one year ago. Ultrasound screening revealed the presence of abdominal ascites which was treated conservatively. Two months post-treatment, the patient developed a pseudocyst in the head of the pancreas and a right-sided pleural effusion that was treated by inserting a plastic stent into the pancreatic duct through endoscopic retrograde cholangiopancreatography (ERCP). This caused inflammation of the pseudocyst, which was eventually drained to the stomach using endoscopy. No recurrence was observed after removing the stents four weeks later.

Invasive techniques like ERCP are necessary for some cases of pancreatic fistulas that do not respond well to conservative treatment.

ERCP is an effective way to diagnose and treat several duct-related complications of traumatic pancreatitis. Although ideal management of such rare conditions remains highly debatable, non-invasive strategies are preferable for pediatric patients.