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[Pancreatic pseudocysts in childhood]
J L Alonso Calderón1, V Rollán Villamarín, A Rodríguez Mínguez
1Servicio de Cirugía Pediátrica, Hospital Niño Jesús, Madrid.
Insights
Infant pancreatic pseudocysts, often linked to blunt abdominal injuries, present with varied symptoms. Surgical intervention is necessary, with cystogastrostomy potentially offering shorter hospital stays than marsupialization.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Abdominal Imaging
Background:
- Pancreatic pseudocysts are rare in infants but increasingly diagnosed due to improved imaging.
- Blunt abdominal trauma is a significant contributing factor in pediatric cases.
- Clinical presentation can be non-specific, leading to delayed diagnosis.
Purpose of the Study:
- To report on four infant cases of pancreatic pseudocysts.
- To analyze diagnostic and therapeutic variations over time.
- To highlight the association with blunt abdominal trauma.
Main Methods:
- Retrospective case series analysis.
- Review of diagnostic imaging (ultrasound, CT).
- Surgical intervention: marsupialization and cystogastrostomy.
Main Results:
- Four infant cases of pancreatic pseudocysts were identified.
- Two patients had a history of blunt abdominal trauma.
- All patients required surgery; cystogastrostomy resulted in shorter hospital stays compared to marsupialization.
Conclusions:
- Pancreatic pseudocysts in infants, though uncommon, require prompt surgical management.
- Surgical approach influences recovery time, with internal drainage potentially being more efficient.
- Early diagnosis and management are crucial for favorable outcomes in pediatric pancreatic pseudocysts.
Abstract:
Pancreatic pseudocysts do not occur frequently in infants, although more cases have been reported in the last years probably due to a more accurate and early diagnosis. These cases have been related to the increasing frequency of blunt abdominal injuries. Half of the four patients presented in this report were found to have suffered from previous blunt abdominal injuries and the common characteristic in all cases was a polymorphic clinical course prior to the discovery of an abdominal mass or progressive abdominal distension. All cases required surgical intervention, including external diversion (marsupialization) in two patients and internal derivation (cystogastrostomy) in the remaining patients. All patients recovered uneventfully after appropriate surgical treatment, although the mean hospital stay in those treated with external drainage was longer. These four cases were observed during a long period of time enabling us to register the variations in diagnostic and therapeutic procedures.