Management of traumatic complete pancreatic fracture in a child: case report and review of literature

J Laparoendosc Adv Surg Tech A. 2008 Apr;18(2):321-3. doi: 10.1089/lap.2007.0103.

Abstract

Blunt abdominal trauma is the most common cause of pancreatic injury in children. Laparoscopic distal pancreatectomy in a child with complete duct disruption has not been reported in the literature in children, although it has been well described in adults.

Methods: In this paper report a case of a 7-year-old male, with grade 4 pancreatic trauma, who was treated nonoperatively in the acute phase and subsequently by laparoscopic distal pancreatectomy 3 months after the trauma.

Discussion: Although in adults the surgical management of grade 3-4 pancreatic traumatic injury is well described, including the laparoscopic approach, no report of laparoscopic distal pancreatectomy was found in the literature. We would like to emphasize the importance of using a conservative management in the acute phase of pancreatic injury, including grade 4 injuries. After this phase, the use of the high-definition computed tomography scan and endoscopic retrograde pancreatography were fundamental.

Conclusion: Magnification of laparoscopic technique allowed us to identify the structures much better than open surgery.

MeSH terms

  • Abdominal Injuries / etiology
  • Abdominal Injuries / pathology*
  • Bicycling / injuries
  • Child
  • Humans
  • Laparoscopy*
  • Male
  • Pancreas / injuries*
  • Pancreas / pathology
  • Pancreatectomy*
  • Pancreatic Ducts / injuries
  • Wounds, Nonpenetrating / pathology