Literature DB >> 25240916

Multi-institutional experience with penetrating pancreatic injuries in children.

Hanna Alemayehu1, Kuojen Tsao, Mark L Wulkan, Saleem Islam, Robert T Russell, Todd A Ponsky, Daniel C Cullinane, Adam Alder, Shawn D St Peter, Corey W Iqbal.   

Abstract

PURPOSE: Penetrating pancreatic injuries in children are uncommon and are not well described in the literature. We report a multi-institutional experience with penetrating pancreatic injuries in children.
METHODS: A retrospective review of children sustaining penetrating pancreatic injuries was performed at eight pediatric trauma centers.
RESULTS: Sixteen patients were identified. Eleven patients were male; (mean ± SE) age was 11.7 ± 1.2 years. The mechanism of injury was gun-shot wound in 14 patients and mean injury-severity score was 18 ± 3. All patients had associated injuries, most frequently small bowel injuries (n = 9). Patients had either grade I (n = 4), grade II (n = 7), or grade III (n = 4) injuries; there was a single grade V injury. All patients underwent exploratory celiotomy. Drainage of the injured pancreas was performed in 11 patients, and 2 patients underwent pancreatorrhaphy in addition to drainage; 3 underwent resection for grade III (n = 2) and grade V (n = 1) injuries. Thirteen patients required other intra-abdominal procedures. All patients required intensive care over a mean 11.0 ± 3.0 days. Mean duration of stay was 30.1 ± 5.6 days. Post-operative morbidity was 62.5% with no mortalities.
CONCLUSIONS: Penetrating pancreatic injuries in children are uncommon and most often due to firearms. There is a high association with other injuries particularly hollow viscous perforation.

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Year:  2014        PMID: 25240916     DOI: 10.1007/s00383-014-3599-2

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


  16 in total

1.  Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum.

Authors:  E E Moore; T H Cogbill; M A Malangoni; G J Jurkovich; H R Champion; T A Gennarelli; J W McAninch; H L Pachter; S R Shackford; P G Trafton
Journal:  J Trauma       Date:  1990-11

2.  Long-term outcome after nonoperative management of complete traumatic pancreatic transection in children.

Authors:  P W Wales; B Shuckett; P C Kim
Journal:  J Pediatr Surg       Date:  2001-05       Impact factor: 2.545

3.  Management of penetrating pancreatic trauma: an 11-year experience of a level-1 trauma center.

Authors:  J C Vasquez; R Coimbra; D B Hoyt; D Fortlage
Journal:  Injury       Date:  2001-12       Impact factor: 2.586

4.  Operative vs nonoperative management for blunt pancreatic transection in children: multi-institutional outcomes.

Authors:  Corey W Iqbal; Shawn D St Peter; Kuojen Tsao; Daniel C Cullinane; David M Gourlay; Todd A Ponsky; Mark L Wulkan; Obinna O Adibe
Journal:  J Am Coll Surg       Date:  2013-10-25       Impact factor: 6.113

5.  The management of pancreatic injuries in children: operate or observe.

Authors:  Michael D Paul; David P Mooney
Journal:  J Pediatr Surg       Date:  2011-06       Impact factor: 2.545

6.  Pancreatic injuries resulting from penetrating trauma: a multi-institution review.

Authors:  P R Young; J W Meredith; C C Baker; M H Thomason; M C Chang
Journal:  Am Surg       Date:  1998-09       Impact factor: 0.688

7.  Blunt pancreatic injuries in children: the role of percutaneous external drainage in the treatment of pancreatic pseudocysts.

Authors:  J Bass; M Di Lorenzo; J G Desjardins; A Grignon; A Ouimet
Journal:  J Pediatr Surg       Date:  1988-08       Impact factor: 2.545

8.  Management of blunt pancreatic injury in children.

Authors:  E P Nadler; M Gardner; L C Schall; J M Lynch; H R Ford
Journal:  J Trauma       Date:  1999-12

Review 9.  Diagnosis and management of blunt abdominal solid organ injury.

Authors:  Thomas J Schroeppel; Martin A Croce
Journal:  Curr Opin Crit Care       Date:  2007-08       Impact factor: 3.687

10.  Penetrating pancreatic injuries, 1978-1983.

Authors:  V J Sorensen; F N Obeid; H M Horst; B A Bivins
Journal:  Am Surg       Date:  1986-07       Impact factor: 0.688

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