Pancreatic Injury in Children: Role of Nonoperative Management

Blunt trauma to the abdomen accounts for the majority of abdominal injuries in children. Pancreatic injury is the fourth most common solid organ injury, following injuries to the spleen, liver and kidneys [1]. Pancreatic injury is a rare but severe complication occurring in 2-5% of blunt abdominal traumas. It is most often caused by compression of the gland against the lumbar part of the vertebral column. Due to contusion, the pancreas often ruptures completely [2,3]. Non-surgical management of minor pancreatic injury is well accepted, but the management of serious pancreatic injury in children remains controversial [4]. Pancreatic injuries often induce severe complications. Some centers recommend an aggressive surgical approach to reduce the incidence of pseudocyst formation and to prevent greater morbidity and prolonged hospitalization. Others advocate that non-surgical management of pancreatic injury in children leads to a good clinical outcome. Early diagnosis and adequate therapy of pancreatic trauma are essential for the prevention of complications. Correct diagnosis can be difficult in blunt abdominal trauma, especially in the case of isolated pancreatic injury, because retroperitoneal lesions do not have any specific symptoms [4,5]. We evaluated the data of 2 cases of pancreatic injury in childhood presented at our department.