Abstract :
Introduction: Pancreatic trauma in children is rare and accounts for less than two percent of blunt abdominal injuries. High grade injuries such as grade four are usually treated surgically. Recent reports suggest that non operative management can be successful in selected stable patients.Case Presentation: A 14 year old boy presented after blunt abdominal trauma. Contrast enhanced CT scan showed a grade four pancreatic injury with transection at the pancreatic neck. The patient was hemodynamically stable and was managed conservatively with bowel rest, nasogastric decompression, parenteral nutrition, intravenous antibiotics and close monitoring. He improved gradually, resumed oral feeding and was discharged in a stable condition. Follow up showed no evidence of pseudocyst, pancreatic fistula or endocrine dysfunction.Discussion: Although surgery is the traditional approach for high grade pancreatic trauma, conservative treatment can be effective in carefully selected pediatric patients. This avoids the morbidity associated with pancreatic surgery when good monitoring and supportive care are available.Conclusion: Conservative management of grade four pancreatic trauma in a child can be safe and effective. Careful patient selection and close follow up are essential for successful outcomes.
Keyword :
Pediatric pancreatic trauma, Grade four pancreatic injury, Conservative management, Blunt abdominal trauma, Case report