Sheng Xinyi,Ji Chunyi,Yuan Miaoxian,et al.Diagnosis and treatment of high-grade pancreatic trauma in children[J].Journal of Clinical Pediatric Surgery,,21():1164-1167.[doi:10.3760/cma.j.cn101785-202206061-012]
Diagnosis and treatment of high-grade pancreatic trauma in children
- Keywords:
- Pancreatic Diseases; External injury; Pancreatectomy; Diagnosis; Therapy; Child
- Abstract:
- Objective To explore the treatment of high-grade pancreatic trauma in children.Methods From January 2018 to January 2022,clinical data were retrospectively reviewed for 12 children hospitalized with grade Ⅲ or above pancreatic trauma.Course of disease,clinical manifestations,changes of blood and urine amylase,imaging studies,treatments and outcomes were recorded.Results There were 7 boys and 5 girls with an age range of (29-139) months.The course of disease ranged from 5 hours to 15 days post-injury.Elevations of blood and urine amylase were detected in 11 children.Among 9 cases complicated with abdominal organ injury,there were grade Ⅲ pancreatic injury (n=8) and grade Ⅳ pancreatic injury (n=4).Among 8 cases of grade Ⅲ pancreatic injury,three cases underwent pancreatectomy (splenic preservation,n=2;splenectomy;n=1) and giant pseudocyst was punctured with external drainage (n=5).Mean fasting time and hospital stay of grade Ⅲ children undergoing distal pancreatectomy were (6.3±1.15) and (15.6±6.03) days.The mean values of fasting time and hospital stay were (30±13.2) and (51.8±4.49) days.None of 4 cases with grade Ⅳ extrapitonal injury had life-threatening complications.One underwent injury-controlled drainage while the remainders were treated conservatively by internal drainage of giant pancreatic pseudocyst.The fasting time and hospital stay of drainage cases were 43 and 56 days.Mean fasting time and hospital stay were (45.3±7.1) and (57.3±4.4) days.All of them recovered smoothly.Conclusion Distal pancreatectomy for grade Ⅲ pancreatic trauma can effectively shorten fasting and hospital stay as compared with conservative treatment.Distal pancreatectomy is preferred for preserving spleen as much as possible.For grade Ⅳ pancreatic trauma,there is generally no serious life-threatening complication.Drainage surgery has no obvious edge over conservative treatment and conservative treatment is recommended.If other abdominal organ injuries require early post-injury surgery,injury-controlled drainage is indicated.
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Memo
收稿日期:2022-6-29。
基金项目:湖南省卫健委课题(20200212)
通讯作者:尹强,Email:qiangyin@hotmail.com