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MANAGEMENT OF TRANSECTED PANCREAS IN CHILDREN
Author(s) -
McGahren E. D.,
Magnuson D.,
Schaller R. T.,
Tapper D.
Publication year - 1995
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1995.tb00620.x
Subject(s) - medicine , pancreas , general surgery
The pancreas is the fourth most commonly injured intra‐abdominal organ in children who sustain blunt abdominal trauma. Appropriate management of the injured pancreas has been controversial. With the advent of the computerized tomography scan, paediatric surgeons have tended to manage pancreatic injuries non‐operatively. However. if pseudocysts develop. non‐operative management may necessarily entail a long hospital course involving total parenleral nutrition. drainage procedures and attendant morbidity. The critical element in planning therapy is to determine the status of the pancreatic duct. We have recently encountered five children who suffered blunt pancreatic injury where the main pancreatic duct was determined to have been transected. These children underwent spleen preserving distal pancreatectomy with resultant shorter hospital stays and minimal long‐term morbidity. We suggest that in children with pancreatic injury where the main pancreatic duct has been transected early operative management rather than non‐operative therapy is the procedure of choice. Endoscopic retrograde cholangiopancreatography should be used to determine the status of the pancreatic duct. This modality can be both diagnostic and therapeutic in appropriate circumstances.