Related Experiment Videos
Pancreatic trauma in children: mechanisms of injury
M S Arkovitz1, N Johnson, V F Garcia
1Division of Pediatric Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Insights
Handlebar injuries are a common cause of pancreatic trauma in children. A double contrast computed tomographic scan is recommended for diagnosing pancreatic injury in children with abdominal pain and elevated serum amylase.
Area of Science:
- Pediatric Trauma Surgery
- Abdominal Imaging
- Pancreatic Injury Diagnosis
Background:
- Pancreatic trauma affects up to 10% of pediatric blunt trauma cases.
- Identifying diagnostic markers for pediatric pancreatic injury is crucial.
- Assessing current diagnostic strategies for pancreatic injury in children is needed.
Purpose of the Study:
- To identify markers for pancreatic injury in children.
- To evaluate the diagnostic approach for pediatric pancreatic injury.
Main Methods:
- Retrospective chart review of pediatric patients with pancreatic injury.
- Inclusion criteria: patients admitted to a Level I pediatric trauma center (1980-1994).
Main Results:
- 26 children with blunt pancreatic trauma were analyzed.
- Handlebar injuries were the most frequent mechanism, causing isolated pancreatic trauma and pseudocysts.
- CT scans with double contrast showed 85% sensitivity for diagnosing pancreatic injury.
Conclusions:
- Double contrast CT scans are more sensitive than ultrasound for diagnosing pancreatic injury.
- Hospitalization and CT scan are warranted for children presenting with abdominal pain, elevated serum amylase, and handlebar injury.
Background:
Pancreatic trauma occurs in up to 10% of all cases of blunt pediatric trauma. Here we attempted to identify markers of pancreatic injury in children and to assess our current diagnostic approach to pancreatic injury.
Method:
We performed a retrospective chart review of all patients with a pancreatic injury admitted to a Level I pediatric trauma center between January of 1980 and September of 1994.
Results:
In all, 26 children were included. All pancreatic injuries were due to blunt trauma. Handlebar injuries were the most common mechanism of injury and resulted in a unique pattern of isolated pancreatic trauma, often complicated by the development of a pseudocyst. Computed tomographic scans, performed with intravenous and oral contrast and done in the acute setting, were 85% sensitive for diagnosing a pancreatic injury.
Conclusions:
Double contrast computed tomographic scan is a more sensitive test than ultrasound in diagnosing pancreatic injury. The constellation of abdominal pain, an elevated serum amylase and a handlebar mechanism of injury warrants hospitalization and a double contrast abdominal computed tomographic scan.